Prescription Drug Plan - Active Employee

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Prescription Drug Plan 2016 - 2017

Your prescription drug benefits are a part of your UT SELECT Medical Plan and are administered by Express Scripts.

ANNUAL DEDUCTIBLE  
(does not apply to medical plan deductible) 

$100/person/year
ACCESS OPTIONS  Generic Drug  Copayment Preferred Drug  Copayment Non-Preferred Drug  Copayment
Retail Network Pharmacy: 
Up to a 31-day supply. Refills allowed as prescribed. (good option for new prescriptions)
$10  $35  $50 
Home Delivery Pharmacy: 
Up to a 90-day supply. Refills allowed as prescribed.  
(best option for maintenance medication)
$20  $87.50  $125

If you purchase a preferred or non-preferred drug when a less expensive generic alternative drug is available, you must pay the difference between the cost of the brand name drug and the generic drug  plus the applicable generic copayment . This difference does NOT count toward your annual deductible. Sometimes the cost difference is quite large.

The generic, preferred, or non-preferred list of covered drugs is reviewed periodically resulting in changes to the prescription drug list throughout the year. If you are taking a medication that is affected by one of these changes, Express Scripts will mail a letter to your address on file to alert you of the change in benefits. Please refer to the Express Scripts website at www.express-scripts.com/ut or call Express Scripts Customer Service ( 1- 800-818-0155 ) for current information on specific medications.


 

Resources

Contact

Express Scripts CUSTOMER SERVICE  (800) 818-0155

CLAIMS ADDRESS 
Express Scripts  
ATTN: Commercial Claims  
PO BOX 2872  
Clinton, IA 52733-2872