Express Scripts
Benefits are provided through Express Scripts, a point-of-service provider. Please call 800-206-4005 for questions regarding benefits or network participating pharmacies or visit online at www.express.scripts.com
Preferred Drug List
Submitting a Claim
Within the first six weeks of enrollment
If a new Insured Person incurs Rx claims within the first six weeks of enrollment, the Covered Person must pay for the Rx and submit a claim to Express Scripts after the sixth week.
MAIL ORDER PHARMACY
There are several options for members to fill their first fills at the mail order pharmacy:
AMC Mail Order ESI fax form.pdf
AM2-Mail Order.doc
After six weeks*
After six weeks, the Covered Person may go to any network pharmacy and present their insurance card. The co-payment is $15 for generic drugs, $40 for brand name drugs, or $60 for non-formulary drugs, for eligible prescription drugs up to a 30 day supply per prescription or refill.
- When a generic drug is available and you choose to purchase a brand name drug, even when the doctor writes “dispense as written” or “may not substitute,” you must pay the cost difference between the brand name prescription and the generic prescription, in addition to your co-insurance.
- If you do not use a participating pharmacy, you are responsible for the full cost of the prescription. For information about participating pharmacies or to obtain other information, please call Express Scripts at 800-206-4005.
*Once you have received an insurance/prescription card this means you are in the system and can just present your card at the pharmacy and no longer have to submit a claim form to Express Scripts.