Page 9 - Busey 2021 Annual Benefits Enrollment
P. 9
First Busey Corporation Benefits Guide
Prescription Drug Coverage
Prescription drug beneits under all plans is offered through Express Scripts. Our plan utilizes Express Scripts’
full network.
The below chart outlines the beneits for the prescription drug plan. The prescription drug beneits on these plans
are based on whether the drug is considered a generic, preferred brand, or non-preferred brand. Our plan allows for
a 30-day supply at a retail pharmacy, or a 90-day supply through mail order. New in 2021, we will utilize the Express
Scripts’ Smart90 program.
The Smart90 program is speciic to our members who utilize long-term drugs, also called maintenance medications,
that are taken on an ongoing basis. The Smart90 program is intended to save you trips to the pharmacy, allow for
payments every three months vs. monthly, and create lower overall prices due to purchasing in larger quantities.
Express Scripts Pharmacy will deliver your 90-day supply medications to your door for free; you also have the
option to ill your prescription in person at any in-network retail pharmacy.
Under the Smart90 program, you will need to make an active election by visiting express-scripts.com/90day, to
continue to ill your maintenance medications with a 30-day or 90-day supply. If you do not make an active election,
you will be defaulted into being covered only by the 90-day supply. This means you will be responsible for the full
retail cost of your 30-day supply of maintenance medications moving forward. For more information, or if you
need help locating a pharmacy, visit express-scripts.com.
With a CDHP plan, all prescription drugs are subject to the medical deductible before cost sharing begins. You will,
however, see 100% coverage on certain preventive medications under the CDHP plan.
Prescription Drugs
POS 2800 CDHP POS 5000 CDHP
In-Network Out-of-Network In-Network Out-of-Network
Retail—Supply Limit 30 days 30 days
Tier 1 80% after deductible 50% after deductible 100% after deductible 50% after deductible
Tier 2 80% after deductible 50% after deductible 100% after deductible 50% after deductible
Tier 3 80% after deductible 50% after deductible 100% after deductible 50% after deductible
Mail Order—Supply Limit 90 days 90 days
Tier 1 80% after deductible 100% after deductible
Tier 2 80% after deductible Not covered 100% after deductible Not covered
Tier 3 80% after deductible 100% after deductible
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Prescription Drug Coverage
Prescription drug beneits under all plans is offered through Express Scripts. Our plan utilizes Express Scripts’
full network.
The below chart outlines the beneits for the prescription drug plan. The prescription drug beneits on these plans
are based on whether the drug is considered a generic, preferred brand, or non-preferred brand. Our plan allows for
a 30-day supply at a retail pharmacy, or a 90-day supply through mail order. New in 2021, we will utilize the Express
Scripts’ Smart90 program.
The Smart90 program is speciic to our members who utilize long-term drugs, also called maintenance medications,
that are taken on an ongoing basis. The Smart90 program is intended to save you trips to the pharmacy, allow for
payments every three months vs. monthly, and create lower overall prices due to purchasing in larger quantities.
Express Scripts Pharmacy will deliver your 90-day supply medications to your door for free; you also have the
option to ill your prescription in person at any in-network retail pharmacy.
Under the Smart90 program, you will need to make an active election by visiting express-scripts.com/90day, to
continue to ill your maintenance medications with a 30-day or 90-day supply. If you do not make an active election,
you will be defaulted into being covered only by the 90-day supply. This means you will be responsible for the full
retail cost of your 30-day supply of maintenance medications moving forward. For more information, or if you
need help locating a pharmacy, visit express-scripts.com.
With a CDHP plan, all prescription drugs are subject to the medical deductible before cost sharing begins. You will,
however, see 100% coverage on certain preventive medications under the CDHP plan.
Prescription Drugs
POS 2800 CDHP POS 5000 CDHP
In-Network Out-of-Network In-Network Out-of-Network
Retail—Supply Limit 30 days 30 days
Tier 1 80% after deductible 50% after deductible 100% after deductible 50% after deductible
Tier 2 80% after deductible 50% after deductible 100% after deductible 50% after deductible
Tier 3 80% after deductible 50% after deductible 100% after deductible 50% after deductible
Mail Order—Supply Limit 90 days 90 days
Tier 1 80% after deductible 100% after deductible
Tier 2 80% after deductible Not covered 100% after deductible Not covered
Tier 3 80% after deductible 100% after deductible
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