October 17, 2016

New pharmacy provider to manage prescription benefits for 2017

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PharmacyUAB has negotiated a new prescription benefit with Express Scripts that applies to all its health insurance choices — traditional and the consumer-driven plans — beginning Jan. 1, 2017. Co-pays for prescriptions will not change, but a new co-pay assistance program for certain specialty medications will enable those who qualify to reduce their out-of-pocket costs.

Employees who enroll in a UAB health plan during open enrollment Oct. 28-Nov. 14 will receive a welcome package in December from Express Scripts that explains the benefit and provides instructions for accessing the prescription services in 2017. Express Scripts offers an extensive network of participating retail pharmacies plus home delivery for 90-day supply of long-term medications at a discounted rate.

You can manage your pharmacy needs online beginning Jan. 1, 2017, at www.express-scripts.com, using its mobile app or by phone with representatives available around the clock to answer questions about your benefit or assist with orders. Caremark will continue providing pharmacy services for the remainder of 2016.

Several options are available to employees to help reduce their costs for prescription drugs. 

Generic drugs

Generic drugs offer the lowest cost for prescriptions filled through retail pharmacies or home delivery. Employees will pay $15 for a 31-day supply or $45 for a 90-day supply in the store. A 90-day supply of generic drugs through mail order is only $30 — basically three months for the price of two; more on that below.

By comparison, the price is $35 for a preferred brand and $60 for non-preferred brands for the same 31-day retail supply.

To find out how your medication is classified or if a medication has a generic equivalent, beginning Jan. 1, 2017, log in the Express Scripts website and choose “Price a medication” from the drop-down menu under “Manage Prescriptions” or you can contact Member Services.

Home delivery discount

For employees and family members who require medications to treat an ongoing condition, such as high blood pressure, high cholesterol or diabetes, using home delivery services for a 90-day maintenance supply offers substantive cost savings during the year when compared with retail prices.

  • For generics, the cost is $30 for a 90-day supply, which saves $60 per year for each eligible prescription.
  • If you use a preferred brand, the cost for a 90-day supply is $88, which saves $68 per year for each eligible prescription.
  • For those who require a non-preferred brand, a 90-day supply is $150, which saves $120 annually for each prescription.
If you are already using home delivery, prescriptions with refills remaining at the beginning of the plan year can be transferred to Express Scripts for all drugs except controlled substances; those will require a new prescription from your doctor. Instructions for doing that will be in your welcome package.

Information about benefit options are being provided to better enable you to make the best choices for your household. 
5 things to know about open enrollment 
Things to know about vision and dental plans 
New consumer-driven health plan and HSAs
Traditional plan options for 2017
6 ways to reduce your health care costs

Co-pay assistance

Express Scripts offers a service to help specialty medication patients take advantage of co-pay assistance programs that are offered directly through the drug manufacturer, a foundational organization and/or state agencies. Express Scripts will enroll qualified employees in the programs to ensure they pay the lowest price available to them.

The co-pay assistance program targets specialty medication to include, but not limited to, oncology, rheumatoid arthritis and multiple sclerosis drugs that are filled through its Accredo Specialty Pharmacy program.

More detailed information about all benefits options is available in the Open Enrollment toolkit in the UAB for Me portal at www.uab.edu/hrintouch. This includes plan details, educational pieces, FAQs, decision-making tools and other resources that can help you make selections. This will replace the packet of printed information that had been mailed to employees’ homes in prior years.

The UAB Benefits Fair will be held 7 a.m.-4 p.m. Nov. 3 in the UAB Hospital West Pavilion Atrium to help answer any questions you may have before choosing your benefits for 2017. Can’t make it? Contact your HR consultant or the UAB Benefits office, benefits@uab.edu or 934-3458.

Using your prescription benefits

  • Make certain you have your new card (Viva members have one card for both medical and pharmacy; BCBS members have a separate pharmacy card.)
  • There is a $100 (single) and $200 (non-single) annual deductible that begins Jan. 1, 2017.
  • Pharmacy copay tiers did not change for 2017.
If there are problems, call or contact:
  • Express Scripts, 1-855-778-1485
  • Viva Health (customer service for all UAB Rx), 1-800-294-7780
  • UAB Benefits Office, Benefits@uab.edu or 205-934-3458