Current Provider: Express Scripts
- Group Name and Rx Bin: WUSTLRX #003858
- Customer Service: 1-877-880-1877
- Forms & Plan Documents
Regardless of whether you are enrolled in a United HealthCare (UHC) or Anthem Blue Cross Blue Shield health plan, your prescription drug benefits are administered by Express Scripts.
With the exception of the High Deductible Health Plan (HDHP), drugs are categorized by tier. Tier One is primarily generic drugs; Tier Two is primarily preferred brand name drugs; and Tier Three is primarily non-preferred brand name drugs. With the HDHP, you must pay the full negotiated cost of the drug until your HDHP deductible is satisfied; then, you pay a 20% co-insurance.
|Co-Payments/ Co-Insurance||All health plans except UnitedHealthcare HDHP||UnitedHealthcare HDHP|
|30-Day Retail||90-Day Mail-Order||30-Day Retail||90-Day Mail-Order|
|Tier One||$12*||$30*||20% co-insurance after deductible|
$40 min – $80 max
$100 min – $200 max
$60 min – $120 max
$150 min – $300 max
|Specialty Drugs||Generic – $12 per 30-day supply
Brand – $100 per 30-day supply
|Out-of-Pocket Maximum||$2,500 – Individual; $5,000 – Family||HDHP Out-of-Pocket Maximum applies|
*For generic drugs used to treat diabetes and heart disease drugs for high cholesterol and hypertension only, co-pay is $4 retail, $10 mail-order.
For short-term prescriptions, use a retail pharmacy. As an Express Scripts member, you can go to any of over 50,000 retail pharmacies, including most major drugstores. To locate a participating Express Scripts pharmacy, log on to Express-scripts.com and select “Locate a Pharmacy” under the Manage Prescriptions menu, or call Express Scripts at 1-877-880-1877.
For long term (non-specialty) medications, use the Express Scripts Pharmacy mail order program for cost-savings. Through Express Scripts Pharmacy, you can obtain up to a 90-day supply of your maintenance medications. Your medications will be mailed to your home, with free standard shipping. To use the mail order program, complete the Express Scripts Pharmacy prescription order form and send it along with your doctor’s prescription and your applicable co-payment to Express Scripts Home Delivery Services, P.O. Box 66577, St. Louis, MO 63166.
To determine what your co-pay will be for a prescription drug under either the retail pharmacy or mail order program, log on to Express-scripts.com and then select “Price a Medication” under the Manage Prescriptions menu. If you are not yet enrolled in a WUSTL health plan or are thinking of changing to/from the High Deductible Health Plan (HDHP) during Open Enrollment, log on to Express Scripts’ Open Enrollment website at Express-scripts.com/wustl to price a medication:
- On the welcome page, select “Open Enrollment Information”
- On the next page, select “WUSTL Actives” if you are enrolling in any WUSTL health plan other the HDHP or select “WUSTL HDHP” if you are enrolling in the High Deductible Health Plan
- On the following page, select “Compare prescription medication costs”
- On the Price a Medication page, enter the name of your medication and follow the prompts thereafter to obtain your cost for a 30-day retail or 90-day mail-order supply of your medication
For specialty medications (those high-cost infused, injectable or oral drugs that are used to treat rare or complex conditions such as cancer, hemophilia, multiple sclerosis and rheumatoid arthritis), contact Accredo, Express Scripts’ specialty pharmacy, at 1-800-501-7210. Certain specialty medications may be limited to a 30-day supply.
To request a replacement Express Scripts ID card or Print a temporary ID card, if you are already enrolled in a WashU health plan:
- Log on the Express-scripts.com.
- If you are already registered on express-scripts.com, enter your user name and password to log on.
- If you are not yet registered on express-scripts.com, select “Create Online Account.” To create your online account, you will need to enter your 12 digit Express Scripts member number, which you can obtain by calling Express Scripts Customer Services at 1-877-880-1877.
- Once you are logged on to express-scripts.com, select “Print & Request Forms & Cards” under the Health and Benefits Information menu.