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Prescription Costs

Our pharmacy plans provide members with options for saving on the cost of their prescription drugs.

  • Most of the 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 medication costs will depend upon which plan your group offers.
  • For those with a Kaiser plan, a Cigna Consumer-Directed Health Plan, an Anthem Blue Cross and Blue Shield Consumer-Directed Health Plan, or another fully-funded local or regional plan, pharmacy benefits are integrated into the medical plan.

Express Scripts

Filling Prescriptions

Retail Pharmacies
More than 67,000 participating retail pharmacies offer discounts with an Express Scripts ID card. Prescriptions may also be filled at any non-participating retail pharmacy, but may incur higher cost shares.

Members who want to buy maintenance medications at a retail pharmacy may do so up to three times (one original and two refills). After three retail refills, maintenance medications must be refilled by home delivery.

Home Delivery - 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 benefits and Express Scripts retail discounts, members can manage costs by using generic drugs on Express Scripts 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:

Cigna to Acquire Express Scripts

On March 8, 2018 Cigna announced that it will acquire Express Scripts. This transaction will not change your benefits or how you obtain your prescriptions at this time. Learn more about the proposed transaction here.

Other Plans

If you offer a Kaiser plan, a Cigna Consumer-Directed Health Plan, an Anthem Blue Cross and Blue Shield Consumer-Directed Health Plan, or a fully-funded local or regional plan to your employees, pharmacy benefits are integrated into the medical plan. For information about prescription drug benefits with these plans, visit the plan websites below, or consult the plan handbook:

Health benefits are offered through plans maintained by Church Pension Group Services Corporation (doing business as The Episcopal Church Medical Trust), 19 East 34th Street, New York, NY 10016.

The Episcopal Church Medical Trust Disclaimer

Unless otherwise noted, websites referenced herein that are outside the www.cpg.org domain are not associated with The Church Pension Fund and its affiliates (collectively, the Church Pension Group) and the Church Pension Group is not responsible for the content of any such websites.

The cost of your prescription medication depends on the plan your employer offers. The tables below show the costs for each plan.

See below for definitions of the terms used in the tables.

Express Scripts Standard Plan

 
Retail
Home Delivery
2018
2018
Generic copayment
Up to $10
Up to $25
Preferred Brand-Name
copayment
Up to $40
Up to $100
Non-preferred Brand-Name and Brand Non-Sedating Antihistamines copayment
Up to $80
Up to $200
Dispensing Limits Per
Copayment
Up to 30-
day supply
Up to 90-
day supply

Express Scripts Premium Plan

>

 
Retail
Home Delivery
2018
2018
Generic copayment
Up to $5
Up to $12
Preferred Brand-Name
copayment
Up to $30
Up to $75
Non-preferred Brand-Name and Brand Non-Sedating Antihistamines copayment
Up to $60
Up to $150
Dispensing Limits Per
Copayment
Up to 30-
day supply
Up to 90-
day supply

*Deductible is for Brand-Name medications

CDHP/HSA

 
Retail and Home Delivery
Prescription Drugs
Annual Prescription Deductible
Combined with Medical Deductible
Generic
15% after deductible
Preferred Brand-Name Drugs (designated by Express Scripts
25% after deductible
Brand-Name Drugs Not on Express Scripts Preferred and Brand Non-Sedating Antihistamines
50% after deductible

These charts provide a general description and are provided for informational purposes only. They should not be viewed as an offer of coverage. In the event of a conflict between these charts and the official Plan documents, the official Plan documents will govern. 

Drug Categories

Generic - medications with the same active ingredients and manufactured according to the same strict federal regulations as their brand-name counterparts.

Brand-Name - a drug patented by the manufacturer and sold by its brand name.

Preferred  - generic and brand-name drugs that are preferred by your plan because they help to control rising prescription drug costs.

Non-preferred - generic and brand-name drugs that are not included on your plan's preferred list. They may be covered, but you may be required to pay a higher cost.

 

Health benefits are offered through plans maintained by Church Pension Group Services Corporation (doing business as The Episcopal Church Medical Trust), 19 East 34th Street, New York, NY 10016.

The Episcopal Church Medical Trust Disclaimer

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Need Help?

Call Client Services for assistance
(855) 215-5990
Monday – Friday
8:30AM – 8:00PM ET
(excluding holidays)

Fax Number
(877) 4-FAX-CPG
(877) 432-9274

Looking for more information, see At-A-Glance Contact List

Need Help?

Call Client Services for assistance
(855) 215-5990
Monday – Friday
8:30AM – 8:00PM ET
(excluding holidays)

Fax Number
(877) 4-FAX-CPG
(877) 432-9274

Looking for more information, see At-A-Glance Contact List