Need help? Call an Express Scripts Medicare Advisor toll free
at 1.877.429.8414, 24 hours a day, 7 days a week, except Thanksgiving.
This information is available for free in other languages.
TTY users, call 1.800.716.3231.
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|Basic prescription drug coverage||Broader coverage of brand drugs|
|$320 deductible||$0 deductible (Tiers 1 & 2 generics)|
|$0 generic drugs (Tier 1) for 31-day supply at over 27,000 pharmacies, including Walgreens||$1 generic drugs (Tier 1) for 31-day supply at over 27,000 pharmacies, including Walgreens|
|$3 generic drugs (Tier 1) for 90-day supply with home delivery||$0 generic drugs (Tier 1) for 90-day supply with home delivery|
*Other pharmacies are available in our network. Our network includes pharmacies with standard and preferred cost-sharing. Members may use any of our pharmacies, but costs may be lower at a pharmacy offering preferred cost-sharing. Those who receive low-income subsidy assistance (Extra Help) pay the same amount as set by Medicare at any network pharmacy.
The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.
Express Scripts Medicare (PDP) is a prescription drug plan with a Medicare contract. Enrollment in Express Scripts Medicare depends on contract renewal.
This page was last updated on 10/01/2014.
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