Drug Card Program |
This program is administered by Express Scripts (ESI) who will issue you an ID card when you become eligible. Most pharmacies participate in the program, which provides you and the Plan with discounted prices on most drugs.
You should only use your Drug Card for short-term prescriptions such as antibiotics—your out-of-pocket costs will be lower if you use the Mail Service Program for your long-term prescription drug needs. |
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Drug Card Benefits |
When you use your Drug Card at a participating pharmacy, you will pay the discounted price and service fee upfront, and submit the prescription drug receipts to Lineco. After the $300 calendar year Comprehensive Medical Benefit deductible is satisfied, the Plan will reimburse you 80% of the discounted price of your covered prescription drugs. For more information, please refer to your SPD. |
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Mail Service Program |
This program provides long-term or maintenance prescription drugs to Plan participants at discounted prices.
The Plan's regular deductible and payment provisions don't apply to prescriptions filled by the mail-service pharmacy. Instead, you pay the following co-pays to Express Scripts each time you order up to a 90-day supply of your medication:
For a 90 day supply of:
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Your Copay |
| Generic drugs |
$10 |
| Preferred brand name drugs (when generic not available) |
$20 |
| Non-preferred brand name drugs |
$35 |
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| Specialty Drugs |
There is also a mandatory mail order program for specialized medications such as high-cost injectable, infusion, intravenous, and certain oral medications. The specialty drug mail order program is administered by Curascript™ (a subsidiary of ESI). These drugs are prescribed for diseases such as multiple sclerosis, rheumatoid arthritis, etc.; they often require special handling and are very expensive, and they are not usually stocked in retail pharmacies. Patients MUST go through Curascript for all specialty drugs, regardless of where the drug will be administered (this includes drugs that will be administered in a doctor's office). Specialty drugs that are not procured through Curascript will not be covered under the Lineco medical plan. Copays for specialized medications are the same as for the mail service program.
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Prescriptions under Medicare |
If you are Medicare-eligible, you will pay a 20% co-pay for your covered prescriptions at retail pharmacies, instead of paying full price and filing a claim for reimbursement. If your 20% co-pays from retail and mail service combined reach $1,000 during a calendar year, you will pay $0 for prescription drug co-pays during the rest of that year. You must use participating pharmacies--no benefit will be provided for out-of-network pharmacy purchases. Also, use of the mail-service pharmacy is mandatory after the original supply plus one refill of any prescription. |
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Additional Information |
Express Scripts
Customer Service: 1-(877)-327-0568
Website: www.express-scripts.com |
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