Your Clients’ Pharmacy Benefits Simplified

May 8, 2024

Understanding pharmacy benefits can be confusing for your clients. That’s why we’re here with the key information you need to simplify pharmacy benefits for your clients and empower them to manage their medications and costs.

Prescriptions by mail

Your clients’ pharmacy benefits are coordinated through Express Scripts. If your clients are taking a long-term medication, Express Scripts may save them time and money. They offer home delivery for up to a 90-day supply of medications and pharmacists who can help them find lower cost alternatives and medication management.

Your clients can get started in a few simple steps by visiting our Mail Order Prescriptions web page.

Drug benefit tiers

Do you get questions from clients about why some medications cost more than others? Understanding how drug tiers work can help you and your clients break down the cost of prescriptions.

To learn about our 4-level drug tiers, visit our Pharmacy Benefit guide web page.

You’ll also want to direct your clients to check their ID cards to see their copay or coinsurance for each drug tier and sign in for plan-specific information about their coverage.

Covered drugs lists

Our drug lists cover thousands of prescription medications. You can search our covered drugs lists as a visitor to see which plans cover the generic or brand-name prescriptions that your clients are taking.

Some drugs require approval to be covered. To find out if a drug is part of our pharmacy prior authorization review, visit our Drugs Requiring Approval web page.

Medication safety program

Our medication safety program supports the safe and cost-effective use of medication and offers tools for members taking 5 or more chronic medications. Direct your clients to check out our medication safety program resources.

Drug reimbursement

Did your client pay full price for a prescription? If your clients forgot their ID card or a pharmacy didn’t accept it by mistake, they can ask us for reimbursement. Direct them to fill out our prescription drug reimbursement form available online.