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Express Scripts Prescription Benefit Manager

On this page: Retail Pharmacies | Cost | Refills and New Rx Orders | Specialty Medications | Things You Can Do

Forms & Publications

Express Scripts manages IU's prescription drug benefit. This benefit covers most prescription drugs, plus insulin and some over-the-counter (OTC) diabetes supplies and certain other OTC items considered preventive.

Retail Pharmacies

Express Scripts pharmacy network includes most retail chain pharmacies, such as CVS, Walmart, Target, and most supermarket pharmacy chains. Some independent pharmacies are included also.

Co-pays and costs

Anthem PPO Plans Co-pays

Retail Pharmacy Prescription Drugs (up to 30-day supply)

  • In-Network:  member pays 20% after deductible (no deductible on Preventive Rx)
  • Out-of-Network: member pays 40% after deductible

Mail Service Pharmacy Prescription Drugs (up to 90-day supply) and Specialty Drugs

  • In-Network:  member pays 20% after deductible (no deductible on Preventive Rx)
  • Out-of-Network: member pays 40% after deductible
IU Health Plan Co-Pays

Retail Pharmacy Prescription Drugs (up to 30-day supply)

  • In-Network: member pays 20% after deductible (no deductible on Preventive Rx)
  • Out-of-Network: no coverage

Mail Service Pharmacy Prescription Drugs (up to 90-day supply) and Specialty Drugs

  • In-Network: member pays 20% after deductible (no deductible on Preventive Rx)
  • Out-of-Network: no coverage

For additional information about co-pays and co-insurance costs for prescriptions and/or to find network pharmacies, visit the Express Scripts web site.

Tobacco Cessation Prescription Benefits
IU employee medical plans cover 100 percent of the cost of tobacco cessation prescription and over-the-counter tobacco replacement products. Coverage is limited to a 180-day supply per covered individual per year. Covered prescriptions drugs include Chantix, Zyban (bupropion), and Nicotrol. Over-the-counter products require a prescription in order to be covered under the employee's medical plan.

Refills and New Prescription Orders

Mail order refills and new prescriptions can be requested online, by telephone, or through the U.S. mail with Express Scripts.

Specialty Medications

Express Scripts has a separate arrangement for specialty medications through Accredo. (Specialty medications are drugs that are used to treat complex conditions, such as cancer, growth hormone deficiency, hemophilia, hepatitis C, immune deficiency, multiple sclerosis, and rheumatoid arthritis.)

Things you can do…

 

Contact

Express Scripts Member Services
800-988-1794

Express Scripts on the Web

Forms

Claim Form (PDF)

Mail Order Form (PDF)

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