Starting January 1, 2021, Express Scripts will administer the prescription drug program for the Medical Plan of the Presbyterian Church (U.S.A.). As the new year approaches, the Board of Pensions is working closely with Express Scripts to make sure this transition goes smoothly for our members.
If you have medical coverage* through the Board, here are five things to know about the move to Express Scripts.
Your prescription drug benefits aren't changing; only the administration is. While plan features like copays, deductibles, and/or coinsurance remain the same, your 2021 costs for specific drugs are based on your medical option, whether the drug is a generic or brand name, and whether it's on the 2021 formulary.
The best way to find out if a medication you're taking is on the formulary — and your 2021 costs for covered drugs — is by visiting the pre-enrollment site express-scripts.com/boardofpensions. You can also call Express Scripts at 800-344-3896. If you are a retired member, you can use the pre-enrollment site to review benefits information and find network pharmacies. To request pricing for covered medications, call the Express Scripts dedicated service line for the Medicare Supplement Plan at 877-856-4694.
Unless they have expired, remaining refills with OptumRx home delivery will automatically transfer to Express Scripts Pharmacy home delivery service. Once the refills have been transferred (shortly after January 1, 2021), you will be able to refill these prescriptions through Express Scripts home delivery. (Note: Prescriptions for controlled substances will not be transferred to Express Scripts.)
Unexpired prior authorization (PA) records also will transfer from OptumRx to Express Scripts. If the PA is no longer valid, your doctor can submit a request for a new PA to Express Scripts on or after January 1, 2021.
You'll receive a welcome package from Express Scripts in December, which will include your new prescription drug ID cards for 2021. Begin using your new cards when filling prescriptions at participating Express Scripts pharmacies starting January 1, 2021.
Learn more about the transition to Express Scripts, including
answers to some questions you may have. Then, be on the lookout for your welcome package in December, along with more information in 2021 about how to get the most from your prescription drug benefits.
*The change to Express Scripts does not apply for members enrolled in Triple-S or GeoBlue.