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Prescription Drugs

Medco, owned by Express Scripts, administers the State Employees' Prescription Drug Plan for all health insurance plans (except retiree Medicare Advantage plans).

  • Prescription Drug Plan members can log into Medco to check the status of an order, see prescription drug history, check for generic alternatives, order mail-order refills and use many other features. Members can also call (877) 531-4793 to speak with a Member Services representative.
  • PPO Plan members should review Medco's Maintenance Drug List to see which prescriptions must be filled at mail order after three fills at a retail pharmacy.
  • Sending multiple prescriptions and order forms in one envelope is considered one order. If Medco needs to follow-up with you or your doctor on any one of the prescriptions, the entire order may be delayed. To avoid this, mail each prescription and order form to Medco separately.
  • Twice a year, Medco updates its Preferred Drug List. Your prescription drug costs will vary based on whether the prescription drug is a generic, a preferred brand or a non-preferred brand.


    • This chart shows the cost savings of using generics and the mail-order pharmacy for maintenance medications.

      Standard PPO and Standard HMOs Health Investor HMO and PPO

     

    Retail
    (up to a 30-day Supply)

    Mail Order Program
    (up to a 90-day Supply)

    Retail and Mail Order**

    Generic

    $7

    $14

    30%

    Preferred Brand Name

    $30

    $60

    30%

    Non-preferred Brand Name

    $50

    $100

    50%
 

Get More for Less - Use Mail Order!

Use the mail-order pharmacy, to receive up to a 90-day supply of medication for the same cost as a two 30-day prescriptions (a 60-day supply) at a retail pharmacy.

  


 

Go Mobile!

Download Medco's smartphone app to manage your account, see your ID card and more.

  

**Member cost of prescription after satisfying the appropriate individual or family annual deductible.

If you request a preferred-brand drug when a generic is available, you must pay the difference between the generic cost and the preferred-brand cost, plus the appropriate copayment or coinsurance. If your physician writes on the prescription that the preferred-brand drug is medically necessary or "dispense as written" and the reason, you pay only the appropriate copayment or coinsurance.

Prescription Drugs - What's the Difference?

Generic medications may look different, but they provide the same level of quality, safety, and effectiveness as the brand-name medicine for a lower price.

Often two brand-name drugs (non-generic) can be used for the same medical issue. One may be less expensive than the other. The less-expensive drug becomes a preferred-brand drug, and the other becomes non-preferred. Check Medco's Preferred Drug List periodically; it's updated twice a year. Sometimes a drug moves from the preferred-brand list to the non-preferred list. If this happens, ask your doctor to prescribe a preferred-brand drug or generic drug that would cost less money and work just as well.


Important Information for Retirees Regarding Medicare Part D and the State Employees' Group Insurance Program

  • Medicare Part D Prescription Drug Plans began January 1, 2006.
  • The State Employees' Group Insurance Program prescription benefit is as good as or better than the Medicare Part D requirements.
  • Canceling health coverage under the State Employees' Group Insurance Program will cancel both health and prescription benefits.
  • If individual retirees cancel coverage under the State Employees' Group Insurance Program, they will not be allowed to re-enroll at a later date.
  • The State Employees' Group Insurance Program will supplement the perscription drug benefits received through Medicare Part D as secondary coverage if a retiree additionally enrolls in a Medicare Part D plan.

View a copy of the state's Medicare Part D Notice of Creditable Coverage.

For more information on Medicare Part D, please visit the Center for Medicare and Medicaid Services at http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/