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Express Scripts has been contracted by the State to provide for pre-paid prescription drug benefits with the use of generic or brand-name drugs with a co-pay. Employees will be charged a higher co-pay for brand-name drugs.
Maintenance drugs may be issued in up to a 45-day supply for one co-pay or up to a 90-day supply for two co-pays.
Exclusions to the program are vitamins (with exception of prescribed pre-natal vitamins), drugs deemed less than effective by the Food and Drug Administration, experimental drugs, dietary supplements, etc.
There is a $1,000 individual ($1,500 for family) out-of-pocket maximum for co-pays during a plan year. If the employee and covered family members reach the out-of-pocket maximum in the plan year, the employee and covered family members will not pay any more in co-payments for the plan year for covered drugs.
Express Scripts also offers a Voluntary Mail Order Program. The employee may choose home delivery of drugs with no additional delivery charge. Drugs can be ordered by phone, mail, or internet. If an employee chooses to take advantage of the Voluntary Mail Order Program, co-payments will be the same as if you visited the retail pharmacy.