Page 8 - 2018 SLU New Hire Guide
P. 8
Prescription Drug Express Scripts Programs
Insurance Card SLU partners with Express Scripts, Inc. (ESI) to implement strategies for
Upon enrollment in the medical curbing the rising cost of pharmacy medications. The programs below are
plan, Express Scripts will send intended to drive better decision making and support healthier outcomes.
you an ID card. If you need to
request a new one, contact Express
Scripts at 888.778.8755 or Voluntary Smart 90 Program
www.express-scripts.com. The Voluntary Smart 90 Program allows members to ill a 90-day supply
Mail Order Program of maintenance medications at Walgreens or through home delivery. By
illing at a 90-day supply, you pay the reduced 90-day supply copay rather
Our prescription beneit through than iling at the 30-day retail copay each time.
ESI provides a mail order program
which allows you to ill a 90-day
supply. If you take a maintenance Out-of-Pocket Protection Program
medication, the Express Scripts
program will require you to make a The out-of-pocket protection program ensures all member’s out-of-
choice between home delivery and the pocket expenses accurately relect the member’s actual spend. Under
retail pharmacy. Members will receive certain circumstances, a member may receive copay assistance for a
communication material directly specialty drug, and their full copay is relected under the plan. This
from ESI which will explain how to program corrects the assistance accumulation, so only the amount a
make your decision about where you
would like to ill your maintenance member spends will be relected in their out-of-pocket maximum. This
medication. Failure to make your program does not take away from any specialty drug assistance the
decision may create disruption in member may receive.
reilling your prescription at a retail
pharmacy.
Advantage Plus Clinical Program Package
You can initiate your participation SLU abides by the recommended level of prior authorization, drug
in the mail order program by
contacting ESI Member Services at quantity management, and step therapy lists—a standard maintained by
888.778.8755. many other members of the St. Louis Business Health Coalition.
Coverage Questions? X Prior authorization: some medications require prior approval before
If you have questions regarding your prescription will be covered
whether or not a prescription is X Step therapy: you must try a generic drug irst before your plan will
covered, please contact customer cover certain brand drugs
service at 888.778.8755. If you
are having issues, your prescription X Quantity limits: quantity limits may apply to certain medications
may be subject to step therapy, according to clinically approved prescribing guidelines; please note the
prior authorization, or drug quantity limits affect only the amount of drug covered under the plan and not
management. whether you can get greater quantities
Please note: if you would like to receive the above affected medications and quantities as
originally prescribed, you may do so but at your own expense.
8 2018 New Hire Guide
Insurance Card SLU partners with Express Scripts, Inc. (ESI) to implement strategies for
Upon enrollment in the medical curbing the rising cost of pharmacy medications. The programs below are
plan, Express Scripts will send intended to drive better decision making and support healthier outcomes.
you an ID card. If you need to
request a new one, contact Express
Scripts at 888.778.8755 or Voluntary Smart 90 Program
www.express-scripts.com. The Voluntary Smart 90 Program allows members to ill a 90-day supply
Mail Order Program of maintenance medications at Walgreens or through home delivery. By
illing at a 90-day supply, you pay the reduced 90-day supply copay rather
Our prescription beneit through than iling at the 30-day retail copay each time.
ESI provides a mail order program
which allows you to ill a 90-day
supply. If you take a maintenance Out-of-Pocket Protection Program
medication, the Express Scripts
program will require you to make a The out-of-pocket protection program ensures all member’s out-of-
choice between home delivery and the pocket expenses accurately relect the member’s actual spend. Under
retail pharmacy. Members will receive certain circumstances, a member may receive copay assistance for a
communication material directly specialty drug, and their full copay is relected under the plan. This
from ESI which will explain how to program corrects the assistance accumulation, so only the amount a
make your decision about where you
would like to ill your maintenance member spends will be relected in their out-of-pocket maximum. This
medication. Failure to make your program does not take away from any specialty drug assistance the
decision may create disruption in member may receive.
reilling your prescription at a retail
pharmacy.
Advantage Plus Clinical Program Package
You can initiate your participation SLU abides by the recommended level of prior authorization, drug
in the mail order program by
contacting ESI Member Services at quantity management, and step therapy lists—a standard maintained by
888.778.8755. many other members of the St. Louis Business Health Coalition.
Coverage Questions? X Prior authorization: some medications require prior approval before
If you have questions regarding your prescription will be covered
whether or not a prescription is X Step therapy: you must try a generic drug irst before your plan will
covered, please contact customer cover certain brand drugs
service at 888.778.8755. If you
are having issues, your prescription X Quantity limits: quantity limits may apply to certain medications
may be subject to step therapy, according to clinically approved prescribing guidelines; please note the
prior authorization, or drug quantity limits affect only the amount of drug covered under the plan and not
management. whether you can get greater quantities
Please note: if you would like to receive the above affected medications and quantities as
originally prescribed, you may do so but at your own expense.
8 2018 New Hire Guide
