Prescription Drugs: Pharmacies
Participating Retail Pharmacy
Your Express Scripts ID card can be used at a network of thousands of participating pharmacies that will provide you with prescription drugs at a discounted price. At a participating pharmacy, you present your ID card, pay the copayment and brand-name differential, if applicable, and receive your prescription. You can find a local pharmacy online at www.express-scripts.com.
Use an Express Scripts participating retail pharmacy when you need short-term or immediate prescriptions. If you need a prescription immediately but will be taking the medication on an ongoing basis, you may ask your physician for two prescriptions: one for a 14-day or 30-day supply that can be filled at a local pharmacy, and one for up to a 90-day supply that can be ordered through the mail order service.
Non-participating pharmacy
If you fill a prescription at a pharmacy that does not participate in the plan's network, the plan will pay only the discounted cost of the drug that a participating pharmacy would have charged. You will be responsible for paying the difference between the discounted price and the actual retail price. At a non-participating pharmacy, you pay for prescriptions when you receive them and get reimbursement from Express Scripts for allowable expenses. To be reimbursed, you and your pharmacist must complete a reimbursement form and you must submit it to Express Scripts.
How to request reimbursement when using a nonparticipating pharmacy
Obtain an Express Scripts reimbursement form from either your campus Benefits Office or directly from Express Scripts.
- Complete and sign the Member/Subscriber/Patient Information on the front side of the form.
- Have the prescription filled, pay the full retail price and request a receipt.
- Have the Pharmacist complete and sign the Pharmacy Information section of the form
- Tape the original receipt to the claim form. Do not use staples or paper clips
- Make copies for your records and mail the reimbursement form and original receipt to: ATTN: Commercial Claims, P.O. Box 2872, Clinton, IA 52733-2872.
After deducting a copayment (and the brand-name differential, if any), Express Scripts will reimburse you for up to a 30-day supply of the drug at the discounted price that a participating pharmacy would have charged.