IF YOU ARE A RETURNING STUDENT ON THE PLAN PLEASE CONTACT AMERIBEN AT 1-855-639-8679 PRIOR TO PICKING UP YOUR FIRST PRESCRIPTIONS FOR PLAN YEAR 12-13 SO THEY CAN VERIFY YOUR ELIGIBILITY. WE SHOULD HAVE THIS ISSUED RESOLVED BY 9/27/12, BUT UNTIL THEN WE MUST RELOAD ALL RETURNING STUDENTS BACK IN THE SYSTEM. OR IF YOU ARE HAVING ANY OTHER ISSUES PLEASE CONTACT AMERIBEN
As many of you are aware we have had a challenging year this
year trying to get the new plan set up.
I apologize for any inconvenience this may have caused you, and I am
here to help expedite any problems.
you are having problems filling prescriptions or need you eligibility on the
plan please contact my office by email firstname.lastname@example.org
I can then have the AmeriBen manually update
the system so you can get the services you need.
As soon as I hear the issues have been
resolved I will post that info.
the reasons it was a combination of the new plan and Health Care Reform, which
does not only affect benefits, but also how the information has to be
transmitted to even little details like the font used in brochures and member
If you did pay for anything out of pocket you may submit
those for reimbursement. You will find
the forms located under form link on this site.
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.
There are several options for members to fill their first fills at the mail order pharmacy:
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.