Benefit Reminders: Prescription Drug Changes for 2016

From the February 2016 Benefits eNews

Generic preferred: You’ll pay more of the cost if you choose a brand-name prescription drug when a generic equivalent is available. Here’s how it works:

  • When you fill a prescription, the pharmacy will determine whether a generic equivalent is available.
  • If a generic is available and you choose the brand-name medication rather than the generic option, you will pay the brand-name copay/coinsurance plus the difference between the cost of the brand-name medication and the equivalent generic medication. The additional cost applies regardless of whether your doctor prescribes a brand-name drug.
  • If a prescription does not have a generic equivalent available, you will pay the brand-name copay/coinsurance (preferred or non-preferred) depending on the drug. (Nearly 80% of all prescriptions filled in the U.S. are now generics and this is only expected to increase.)

Exclusive Home Delivery: This program encourages you to get medication to treat an ongoing medical condition (maintenance medications) through the Express Scripts Exclusive Home Delivery service. Here’s how it works:

  • You can fill a new maintenance medication up to three times at a local retail pharmacy before mail order is required.
  • Beginning with the fourth fill, you will pay the full cost of the drug if you continue to fill at a retail pharmacy. Your cost will not go toward your medical plan annual deductible or annual out-of-pocket maximum.

To order through Express Scripts Exclusive Home Delivery service, visit express-scripts.com, or call 1-866-577-2523.

Need Help Understanding Your Options?

Call Express Scripts at 1-866-577-2523 to speak to a representative who will help you understand all the options available to you.

Good to Know
The Express Scripts mobile app makes it easier for you to you manage your prescription drug benefit from your smartphone. The app provides easy access to drug prices and lower-cost options — such as generic alternatives — under your plan. Discuss the options with your doctor, even while you’re still at the office visit.

Download the free Express Scripts mobile app from Google Play or the iTunes store.

Disclaimer:

The content on this site includes links to tools and information that are not the property of BMC Software, and BMC Software is not responsible for their accuracy, completeness or continued availability. Some of the material contained in this site is based on official plan documents. It is not, nor is it intended to be, the legal plan document or a contract between the company and any employee or contractor. Every effort has been made to ensure the accuracy of this material. In the unlikely event that there is a discrepancy between the site and the official plan documents, the official plan documents will control. BMC Software reserves the right to amend or terminate the plan(s) or program(s) at any time. If you believe the benefits do not describe those available to you, contact the Benefits Center at 877-BMC-4849.

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