Express Scripts Mail-Order Pharmacy
The Express Scripts mail-order pharmacy is available to retirees and their Eligible Dependents who are enrolled in any of the PG&E-sponsored medical plans administered by Anthem Blue Cross.
This program enables you to purchase your maintenance medications, often at a savings, while having them delivered directly to your home via U.S. mail. "Maintenance" medications are those drugs that you take on a long-term or an on-going basis — in other words, those drugs that you know you'll need and can order in advance. Some examples of conditions for which maintenance medications are prescribed are high blood pressure, high cholesterol, heart disorders, diabetes, arthritis and stomach ulcers.
How the Express Scripts Mail-Order Pharmacy Service Works
With Express Scripts' mail-order pharmacy, you may obtain up to a 90-day supply of medication for each prescription. You pay 10% of the cost for each prescription filled with generic drugs, and 20% for those filled with brand-name drugs. If you elect to use a brand-name drug when a generic drug is available, you will be responsible for paying the difference between the price of the generic drug and the brand-name drug, plus coinsurance, as described under Generic Incentive Provision.
Patient Profile
When you order from the Express Scripts mail-order pharmacy for the first time, you will need to complete the last portion of the initial order form, which is a Health Assessment Questionnaire. Complete this form and mail it, along with your original prescription, in an envelope addressed to:
Express Scripts, Inc.
P.O. Box 747000
Cincinnati, Ohio 45274-7000
The mail-order form, which includes the Health Assessment Questionnaire, and mail-order envelopes are available by calling Express Scripts Member Services at 800-718-6590. You may also download the form by accessing Express Scripts' website at www.express-scripts.com.
The purpose of the Health Assessment Questionnaire is to alert the pharmacists who are filling your prescriptions of any allergies or medical conditions that might be affected by the prescriptions you are ordering, in an effort to prevent any potentially harmful drug reactions. All information in the Health Assessment Questionnaire is confidential.
Paying Your Coinsurance
You can request that Express Scripts bill you for your coinsurance, up to $100, or you can instruct Express Scripts to bill your credit card or debit card (e.g., VISA, MasterCard, etc.). Alternatively, you can submit payment in advance. To do so, you will need to call Express Scripts to find out the amount of your coinsurance. Then send your personal check or money order, along with your original prescription, when you send in your order.
Obtaining Your Medications
Express Scripts will mail your medications directly to your home. You will receive your medication within 14 days from the date on which Express Scripts receives your order. If you need your prescription sooner, just let Express Scripts know and, for an extra charge, your prescription will be sent via UPS or Federal Express.
Whenever possible, your prescription will be filled with a generic drug that meets the same standards as the brand name, unless your physician specifies otherwise.
Express Scripts' specialty pharmacy, Accredo Health Group, handles complex conditions such as anemia, hepatitis C, multiple sclerosis, asthma, growth hormone deficiency, and rheumatoid arthritis, which are treated with specialty medications. Specialty medications are typically injectable medications administered either by yourself or by a health care professional, and often require special handling. In addition, Express Scripts partners with Liberty Medical to fulfill prescription requests for certain drugs and supplies covered by Medicare Part B. For more information about Accredo or Liberty Medical, please call Express Scripts Member Services at 800-718-6590.
Ordering Your Refills
You can order your refills by mail or by calling Express Scripts directly at 800-718-6590, 24 hours a day, seven days a week, except Thanksgiving and Christmas. For refills by mail, send the refill slip provided with your last mail-order prescription, along with your copayment, to Express Scripts, Inc., P.O. Box 747000, Cincinnati, Ohio 45274-7000. You may also order your refills online using Express Scripts' website at www.express-scripts.com. You can also check on the status of your refill online.
When Your Current Prescription Expires
Prescriptions expire one year from the date of issue, regardless of whether you have any refills left. You may mail your new prescription to Express Scripts, Inc., P.O. Box 747000, Cincinnati, Ohio 45274-7000. You may also have your physician fax your new prescription to Express Scripts. Ask your doctor to call 888-327-9791 for instructions.