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Prescripti​on Drug Coverage

When you enroll in either of the Ingredion Medical Plan options, you automatically receive prescription drug coverage through Express Scripts.


You choose to have prescriptions filled either at a retail pharmacy or through mail-order (for 90-day supplies only). You save money if you choose to fill via the mail-order program. The amount you pay for a prescription depends on the medication – generic, formulary brand or non-formulary brand. Generic drugs are the least costly category of drugs. Your prescription drug coverage information is located on your BCBS medical ID card. There is no separate ID card for prescription drug coverage. Express Scripts will send a welcome kit to your home which provides more details on the prescription program.

Rx Plan FeatureHSPHRP
 
 DeductiblePreventive drugs are not
subject to the deductible
All drugs are not subject
to the deductible
Non-preventive drugs are subject to the deductible
 
 Retail (30 day supply)Generic $10 copay
Formulary 20% coinsurance ($30 min/$90 max)
Non-formulary 40% coinsurance ($60 min/$180 max)
   
 Mail-Order (90 day supply)Generic $20 copay
Formulary 20% coinsurance ($75 min/$225 max)
Non-formulary 40% coinsurance ($150 min/$450 max)
 

 Do my drug expenses count 
 toward the Out-of-Pocket Max?

Yes
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Express Scripts
1 866 877 8492
www.express-scripts.com

 

  
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ESI Rx 2018 Formulary Exclusion List
ESI Rx 2018 Formulary List
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ESI Rx Drug Quantity Management FAQ
ESI Rx Drug Quantity Management Flyer
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ESI Rx Prior Authorization Flyer
ESI Rx Step Therapy FAQ
ESI Rx Step Therapy Flyer