Pharmacy Benefits


Prescription drug benefits are included with each medical plan. These benefits play a critical role in your coverage, especially when you or your family members regularly rely on prescription drugs to stay healthy.

The prescription drug benefit you receive through Express Scripts offers convenience, cost savings, and flexibility—including the option to fill your prescriptions at a local in-network pharmacy of your choice, or receive up to a 90-day supply, delivered right to your door. To help you make well-informed decisions about your prescription drug needs, Express Scripts offers online tools to help you locate nearby pharmacies, compare costs, and more.

  • With the HSA Plan, once you meet your annual deductible, you and the plan will share in the cost of your prescriptions by paying a predetermined percentage.
  • With the EPO Plan, you do not need to meet your deductible before the plan will share the cost of your prescription drugs. You will owe a copayment or a percentage of the total cost, depending on the prescription, however, you must use a participating Express Scripts pharmacy or the Express Scripts mail order service.

Pharmacy Plan Summary

PrescriptionsHSA PlanEPO Plan
In-NetworkOut-of-NetworkIn-NetworkOut-of-Network
Prescription Deductible (Individual/All Other
Tiers)
Included in MedicalNoneNo coverage
Prescription OOP Maximum (Individual/All
Other Tiers)
Included in Medical$2,500/$5,000No coverage
Retail (30-day supply)
GenericEmployee pays 20% after deductible$15 copayNo coverage
Formulary Employee pays 30% after deductibleEmployee pays 30%
($50 min/$125 max)
No coverage
Non-FormularyEmployee pays 40% after deductibleEmployee pays 50%
($150 min)
No coverage
Home Delivery (90-day supply)
GenericEmployee pays 20%
after deductible
No coverage$40 copayNo coverage
Formulary Employee pays 30%
after deductible
No coverage$125 copayNo coverage
Non-FormularyEmployee pays 40%
after deductible
No coverage Employee pays 50%
($300 min)
No coverage

For more information on the Express Scripts pharmacy benefit if you are not currently enrolled, including searching for in-network pharmacies, prescription drug coverage, visit the Express Scripts website. If you are already an Express Scripts member, visit the Express Scripts log-in portal.