Effective January 1, 2023, the Medical Trust is introducing new prescription drug plan cost sharing for Express Scripts and Kaiser plan members.
Most Medical Trust self-funded health plans include a comprehensive prescription drug benefit through Express Scripts. Groups may offer either the standard or premium pharmacy plan. The member's prescription costs will depend upon which plan your group offers.
Express Scripts' national network of retail pharmacies offer discounts when members present an Express Scripts ID card. Prescriptions may also be filled at any non-participating retail pharmacy, but at a higher cost to members.
Members may fill longer term maintenance medications at a retail pharmacy up to three times (one original and two refills).
Express Scripts Home Delivery Pharmacy is required for most maintenance medications after three retail fills. Members may order up to 90 days of medication at one time, usually at a significant cost savings.
Saving with Generic Drugs
In addition to saving with home delivery and Express Scripts retail discounts, members can manage costs by using generic drugs from the preferred formulary list.
While members and their doctors decide whether or not to use generics, if a member purchases a brand name medication when a generic equivalent is available, the plan will cover only up to the cost of the generic drug.
For more information and questions:
- Visit Express Scripts website
- Call Express Scripts Member Services at (800) 841-3361
- To file a claim for reimbursement use the Prescription Drug Reimbursement Form
If you offer a Kaiser plan, or a fully-funded local or regional plan to your employees, pharmacy benefits are part of the medical plan. For information about prescription drug benefits with these plans, visit the website below, or consult the plan handbook: