` SUNY RF - Benefits

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.

  1. Complete and sign the Member/Subscriber/Patient Information on the front side of the form.
  2. Have the prescription filled, pay the full retail price and request a receipt.
  3. Have the Pharmacist complete and sign the Pharmacy Information section of the form
  4. Tape the original receipt to the claim form. Do not use staples or paper clips
  5. 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.