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Prescription Drugs

WILL I BE REMINDED WHEN IT’S TIME TO REFILL?

Yes – through the communication method you choose. You may also enroll in our auto refills feature online or by calling a patient care advocate.

HOW LONG WILL IT TAKE TO PROCESS MY ORDER?

When you fill a prescription through the Express Scripts Pharmacy for the first time, you can expect delivery of your order within 2 weeks from the time we receive the prescription from your doctor. We recommend that you have a 30-day supply of your medication on hand at the time of your order. Refills typically take 3-5 days to process and ship.

WHICH MEDICATIONS CAN I FILL THROUGH THE EXPRESS SCRIPTS PHARMACY?

You can fill the prescriptions you take regularly for ongoing conditions. The Express Scripts Pharmacy will send a 90-day supply of these“maintenance medications” to your home with free delivery.

MY WRITTEN PRESCRIPTION WAS RETURNED TO ME BY EXPRESS SCRIPTS. WHY?

A prescription may be delayed due to incomplete prescription information, clinical intervention or backorder issues. Approximately 25% to 30% of all new prescriptions received require an Express Scripts pharmacist to contact the doctor or prescriber.

If there is a clinical or administrative concern about your prescription, Express Scripts will attempt to contact your doctor or prescriber up to two times within two business days. If necessary, the Express Scripts Pharmacy will hold the order until the end of the second day, awaiting a response. If a response is not received by the end of the second day, you will receive a letter explaining the situation. When appropriate, the prescription will also be returned to you.

HOW WILL MOVING MY PRESCRIPTIONS TO HOME DELIVERY AFFECT MY USE OF RETAIL PHARMACIES?

You can continue using your retail pharmacy for acute medications, such as antibiotics. You can also use your retail pharmacy for those maintenance medications that are not included in Home Delivery (your standard retail copayment will apply). Remember, you can always speak with a licensed pharmacist at the Express Scripts Pharmacy by calling the toll-free phone number on the back of your member ID card. A patient care advocate (PCA) can connect you with a pharmacist upon request.

HOW LONG IS A WRITTEN PRESCRIPTION VALID?

A prescription is valid for one year from the date it is written, unless it is for a controlled substance, such as narcotics or other addictive medications. A prescription for a controlled substance is valid for six months.

WHERE DO I CALL WITH ADDITIONAL QUESTIONS OR FOR HELP?

You can contact the Express Scripts Patient Care Contact Center at the toll-free number on the back of your member ID card. A patient care advocate (PCA) will assist you and, if needed, can connect your call directly to a licensed pharmacist who will answer any questions, 24 hours a day. You can also find additional information at www.express-scripts.com.

HOW WILL I KNOW IF I HAVE AN OUTSTANDING BALANCE?

You will receive an invoice with each order processed by Express Scripts, as well as monthly statements with any outstanding balances.

WHAT HAPPENS IF MY MEDICATION IS ON MANUFACTURER BACKORDER?

Express Scripts will notify you by phone if a manufacturer is experiencing supply difficulties, and cannot furnish a date of availability. You will be offered several options:

WHAT IS THE DIFFERENCE BETWEEN A CHEMICALLY-EQUIVALENT GENERIC MEDICATION AND A THERAPEUTICALLY-EQUIVALENT GENERIC MEDICATION?

Chemical equivalence occurs when a brand-name and generic drug are made up of the same molecule. For example, Prilosec® and the generic omeprazole are chemical equivalents; the active ingredient in both products is the molecule omeprazole.

Therapeutic equivalence occurs when a brand-name and generic drug provide the same effect on the condition for which they are being taken. For example, Nexium® and the generic omeprazole are different molecules, but are essentially identical in terms of clinical effect.

WILL I GET BRAND-NAME OR GENERIC PRESCRIPTION DRUGS?

You and your doctor can decide what’s best for you. Where permitted by applicable law, FDA- approved generic equivalents may be dispensed when appropriate and permitted by your doctor. These generic medications may save you money. If you prefer, you may submit a note with your prescription to have your order filled only with a brand-name drug. However, this may increase your copayment.

IS HOME DELIVERY AS SAFE AS USING A RETAIL PHARMACY?

Yes. The Express Scripts Pharmacy has a higher accuracy rate (99.9%) than retail pharmacies (98.3%). Automated processes and workload consistency ensure these high levels of safety.

HOW DO I KNOW EXPRESS SCRIPTS WILL FILL MY ORDER CORRECTLY?

Licensed pharmacists check every prescription to make sure it is filled accurately and promptly. The same level of care is exercised at shipping, including special handling for temperature- sensitive prescription drugs.

HOW DO I REFILL MY PRESCRIPTIONS?

Express Scripts now offers Auto Refills, a Home Delivery service enhancement designed to assist you in never running out of your medication. After enrolling your maintenance prescriptions in the program, Express Scripts will automatically calculate your prescription usage and day’s supply remaining. When it’s time to refill your prescription, Express Scripts will fill your maintenance prescriptions automatically for you and mail them to your home. Through your preferred method of communications, we will send you notification 7 days before we begin processing your next refill. You can change the next processing date or cancel the prescription from the automated refills service anytime before processing begins.

There are 3 convenient ways to enroll according to your preference:

  1. Visit our Web site at www.express-scripts.com, click on “Refill Prescriptions” and select the prescriptions you would like to have automatically refilled.
  2. At the time of refilling your prescription, we ask you if you want to enroll the prescription in Auto Refills. If you answer yes, there is nothing more for you to do. We will begin automatically refilling your prescription on all future refills.
  3. You can speak directly to an Express Scripts patient care advocate to enroll your prescription(s) in the program.

If you choose not to enroll in Auto Refills, you may order refills by the following methods:

CAN I HAVE MY PRESCRIPTION SENT OVERNIGHT?

Overnight delivery may be requested with additional shipping and handling charges, although standard processing times still apply. For more information on availability and rates, contact an Express Scripts patient care advocate (PCA) at the toll-free number on the back of your member ID card.

MY MEDICATION NEEDS REFRIGERATION. HOW WILL IT BE MAILED?

The Express Scripts Pharmacy uses special packaging and coolant packs for handling and shipping refrigerated prescription drugs. These processes maintain temperature within the range approved in the product’s labeling. We also adjust for current and forecasted climate conditions, as well as the package destination area.

HOW WILL MY ORDER BE MAILED?

Orders are sent by First-Class Mail in unmarked, tamper-proof packaging ― there is no indication on the package that it is from a pharmacy. They are delivered by your regular carrier, unless the medication requires special handling (such as refrigeration). At your request, we can mail prescriptions to a secondary address.

HOW LONG WILL IT TAKE TO PROCESS MY ORDER?

For first-time orders, please allow 10 to 14 days from the time Express Scripts receives your order for delivery. When mailing a first-time order, we recommend you have at least a 30-day supply of medication on hand. If Express Scripts needs to contact you or your prescribing doctor for information, delivery could take longer. For your first order, we also advise you to get two signed prescriptions from your doctor:

Members should allow two to three weeks to receive their order when Express Scripts has to contact their doctor to obtain a new prescription for Home Delivery. If the doctor cannot be reached, you will receive either a letter or a phone call.

Once we have processed your first order, subsequent refills will be shipped within three to five days from the time the refill request is received.

HOW DO I PAY FOR MY PRESCRIPTIONS?

All orders should include payment information to allow processing without delay. Orders may be paid by:

CAN I SEND IN MORE THAN ONE PRESCRIPTION AT A TIME?

Yes. Express Scripts will process all of the prescriptions according to your benefit.

DO I NEED TO COMPLETE A NEW HOME DELIVERY ORDER FORM EACH TIME I SEND IN A PRESCRIPTION?

No. The form is only necessary the first time you order medication, unless any of your information changes. List all the medications you take, so they can be reviewed for potential interactions. Provide additional information on separate paper, if necessary.

ARE THERE ANY EXCEPTIONS TO THE TYPES OF MEDICATIONS I CAN RECEIVE THROUGH HOME DELIVERY?

There are possible exceptions affecting Home Delivery of certain medications at this time (see chart below for examples). These medications may be filled through Home Delivery from the Express Scripts Pharmacy, if you prefer. For information, contact an Express Scripts patient care advocate (PCA) at the toll-free number on the back of your member ID card.

WHAT MEDICATIONS ARE INCLUDED IN THIS PROGRAM?

The maintenance medications you take regularly for ongoing conditions, such as high blood pressure, high cholesterol and asthma, are included. To find out if a specific prescription drug is considered a maintenance medication on your employer’s prescription-drug plan, please contact an Express Scripts patient care advocate (PCA), using the toll-free number on the back of your member ID card.

WHAT IF I’D PREFER TO GET SOME OF MY MAINTENANCE MEDICATIONS AT MY RETAIL PHARMACY?

You have many opportunities to select which prescriptions you receive through Home Delivery, and those you would like to receive from your retail pharmacy. If you wish to make a change to your current Home Delivery plan, simply call the Express Scripts Member Choice Center (MCC) at 1-877-697-7088, at any time throughout the year and Express Scripts will help you through this process.

HOW DO I ORDER PRESCRIPTIONS THROUGH HOME DELIVERY?

There are four ways to start using the Express Scripts Pharmacy:

  1. Phone –  If you are using Home Delivery for the first time, contact the Express Scripts Member • Choice Center (MCC) at 1-877-697-7088. An MCC representative will set up a Home Delivery profile for you and contact your doctor to obtain a 90-day prescription.
  2. Online –  Visit www.StartHomeDelivery.com. After logging in, click on Save on My Prescriptions to • get started. The Express Scripts Pharmacy will contact your doctor for you to obtain a 90-day prescription.
  3. Mail –  Ask your doctor to write a prescription for up to a 90-day supply of medication (plus refills • for up to one year, if appropriate). Complete a Home Delivery order form. If you don’t have a form, you can print one online • at www.express-scripts.com, or request one from a patient care advocate (PCA) by calling the toll-free number on the back of your member ID card.  Mail the completed order form, your original prescription and payment information to: 

*Faxes must be sent from the doctor’s office. Faxes sent from a member’s home or workplace will not be accepted. Be sure to include your full name, date of birth, mailing address, home phone number and member ID number with all prescriptions.

I WAS ALERTED ABOUT THIS PROGRAM BEING AVAILABLE BY MY RETAIL PHARMACY. WHY IS THIS?

Information on Home Delivery was provided several ways ― through the mail and in open enrollment materials. Express Scripts also routinely sends a letter and makes a phone call explaining the benefits of Home Delivery after you fill a maintenance medication at a retail pharmacy.

WHAT ARE THE BENEFITS OF HOME DELIVERY?

*Savings estimates are based on previous prescription-drug history. Estimates will vary depending on the prescription drugs you are taking and your plan’s Home Delivery benefit.

WHAT IS HOME DELIVERY FROM THE EXPRESS SCRIPTS PHARMACY?

Home Delivery from the Express Scripts Pharmacy provides an affordable way to obtain your maintenance medications, by allowing you to order up to a 90-day supply by mail. It’s the most cost effective way to fill prescriptions — and helps you and your employer save money.

WHO IS EXPRESS SCRIPTS?

Contractors Health Trust Contracts with Express Scripts to manage your prescription drug benefit. Express Scripts makes the use of prescription drugs safer and more affordable for tens of millions of consumers through thousands of employers, government, union and health plans.

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