For short-term prescriptions, take your prescription and your ID card to any Express Scripts participating pharmacy. Once you meet your annual per-person prescription drug deductible, you pay a copay for each prescription. If the drug costs less than the copay, you pay the actual cost instead.

When you have a new prescription for a maintenance medication, you can fill the first two 30-day supplies at any Express Scripts participating pharmacy or through the mail-order home delivery service. After that, you can save considerable money by ordering a 90-day supply through Express Scripts, delivered either by mail or to one of the Express Scripts special 90-day prescription retail partners. CVS and Walgreens are not on this 90-day prescription retail partner list. Partipating retail locations and home delivery forms are available on the Express Scripts website.
 

Important: Be sure to ask your doctor for a 90-day prescription to qualify for the savings.

This plan has no copays nor does it include any no-cost prescription. The cost of the prescriptions are combined with medical plan costs to create one annual deductible of $5,000(individual)/$10,000(family). Until the employee has met the $5,000 deductible (combining both medical and prescription charges), the employee must pay 100% of the cost of the prescription drugs as well as any medical charges. Once the employee has reached the deductible of $5,000/$10,000, all charges are then paid at 100%. That includes all medical as well as prescription costs.

If you are enrolled in the Memorial Hermann ACO or POS Choice medical plans, generic drugs for high blood pressure, high cholesterol, asthma, or diabetes (including injectable insulin) remain available at no cost to you. You will need to purchase 90-day supplies through Express Scripts or at an Express Scripts retail pharmacy partner.

This program does not apply to the High Deductible Health Plan (HDHP).

In compliance with ACA rules, the plan also covers women's generic contraceptives at 100%, as well as those that have no generic available.

Sign up online for automatic prescription refills, and the Express Scripts home delivery service automatically sends your refills and requests a new prescription from your doctor when a maintenance prescription is about to expire or the last refill has been used.

For specialty drugs, which are available only in a 30-day supply, use the Express Scripts specialty mail program or Accredo. SaveonSP is a program that covers certain specialty medications and ensures that, once you are enrolled and eligibility is confirmed, you have lesser financial responsibility for those medications.

Have questions? Call Express Scripts at 855-712-0333 to get started.

The prescription drug plan doesn't cover certain medicines without prior authorization for medical necessity. If you're currently using one of these drugs and don't get authorization from your doctor, you may have to pay the full cost of your medication. Another option is to choose a generic or brand formulary alternative from the Express Scripts formulary. When you choose a drug from this list, you don't have to get prior authorization.

The Express Scripts formulary (drug list) includes generic and brand-name drugs that our medical plan prefers for certain conditions. If you choose drugs that aren't on the list, you may be responsible for the full cost, which can be significantly higher. You can register on the Express Scripts website to see the preferred medications list for our plan, find the price of medications and determine if a medication has any special authorization requirements.

Important: If you or your physician request a brand-name drug when a generic is available, you pay the brand copay PLUS the difference in cost between the two drugs, along with any remaining prescription deductible.

Download the free Express Scripts mobile app for easy refills and timesaving tools and resources, including order history and tracking, drug pricing and help finding your nearest in-network retail partner. 

For more information about prescription drug coverage, call Express Scripts customer service at 855-712-0333 or log on to the Express Scripts website. You can order home delivery online, by phone or by completing a home delivery form (available online) and mailing to the address on the form.