A&M Care 2018 2019 Prescription Drug Program 1
Prescription Drug Benefits Annual Deductible Out of Pocket Maximum Access Options Retail 30 Day Supply: Refills allowed as prescribed. (Good option for new prescriptions) Retail 90 Day Supply: Refills allowed as prescribed $50 per person per year / $150 per family per year (Deductible does not apply to medical plan deductible) Generic Drug Copayment $5,000 Single / $10,000 Family (Deductible applies to Out of Pocket) Preferred Drug Copayment Non-Preferred Drug Copayment $10 $35 $60 $30 $105 $180 Home Delivery Pharmacy: Up to a 90-day supply*. Refills allowed as prescribed (Best option for maintenance medication) $20 $70 $120 * If you obtain a brand-name drug when a generic equivalent is available, you are responsible for the brand copayment plus the cost difference between the brand-name drug and the generic drug. Chart illustrates benefits when network pharmacies are used. Nonnetwork benefits are also available; see Enrollment Guide for more information. 2
A simple pharmacy experience Delivering what matters most to members Info wherever and whenever Help to keep on track Optimize the pharmacy benefit Flexible and personalized options Care from anywhere 3
Have a Question About a Medication? Ask a pharmacist You can contact one of our pharmacists for general counseling or a Specialist Pharmacist for complex concerns. Each Specialist Pharmacist has had specialized training in the medications used to treat a specific condition, such as: You can contact a Specialist Pharmacist 24/7 to ask questions about: High cholesterol High blood pressure Depression Diabetes Asthma Osteoporosis Cancer To reach a pharmacist, call the Express Scripts Member Services number on your ID card Drug interactions Side effects Risks and benefits of your medication The challenges of taking your medication as prescribed one of the best ways to help maintain or improve your health 4
Connecting to Express Scripts is quick and easy with multiple ways to register Patient Care Advocates can register participants online when they call in Or, participants can choose to register on the web or mobile app 5
Member Website Homepage Check order status View all prescriptions and order refills and renewals for themselves or the whole family View savings and transfer retail prescriptions to home delivery Enroll in and manage automatic refills Receive medication-related alerts and take action View important Benefit & Account Notifications Navigate to any feature on the site 6
An app that drives better decisions and healthier outcomes for members on the go Convenience Easy-order refills and up-to-the-minute order status lets members avoid trips to their local pharmacy Peace of Mind Reminders and a drug interaction checker help keep members traveling on the road to good health Simplicity One swipe of the finger is all it takes to stay on track with medications Versatility Flexibility that fits members lives, delivering personalized prescription information whenever & wherever they need it 7
Convenience & Simplicity Virtual ID card 8
Information Resources A&M Benefits Website - https://tamus.edu/business/benefits-administration Pharmacy Benefit Highlights Download Forms Express Scripts Member Website www.express-scripts.com Formulary Information Locate a Participating Pharmacy Health and Wellness Information My Rx Choices / Price a Medication Online Ordering Express Scripts Mobile App Order Home Delivery Pharmacy Refills Caregiver Resources Download forms Customer Service Number: 1-866-544-6970 9
Thank you 10