Express Scripts Copay



Our prescription drug program is administered by Express Scripts. They have a large, nationwide network of retail pharmacies, including Walgreens and local independent pharmacies. The Plan pays benefits when you fill your prescriptions at a network pharmacy or by mail order. Prescriptions for 31 to 90 days can be filled by mail order or at a Walgreens retail pharmacy.

Express Scripts pharmacists, available by phone 24/7 to answer questions about your medications, even in the middle of the night Express Scripts specialty-trained pharmacists, with expertise in the drugs used to treat specific conditions, such as diabetes, high blood pressure and high cholesterol, and who help you get the most from your treatment. Express Scripts helps millions of Americans get their medication and save money. We cover your medication just like health insurance covers a doctor’s visit. We're available 24/7 to help you find the pharmacy with the best prices, handle your household medication needs, or get answers about your therapy from our pharmacists. Up to $750.00 maximum copay /script Above applies until MOOP is reached. 90-day Supply Express Scripts By Mail (Home Delivery) Using Express Scripts By Mail Tier 1 - Generics - no cost to member Tier 2 - 25% coinsurance up to $300.00 maximum copay / script Tier 3 - 33% coinsurance up to $600.00 maximum copay / script. Express Scripts Medicare offers insulin at an affordable and predictable price with our Saver and Choice plans. You will pay $35 or less for select insulin medications from any network pharmacy, in all stages up to the Catastrophic Coverage Stage. View a list of the included drugs. If you receive 'Extra Help,' you do not qualify for this.

What you pay

Preventive Care Medication

Express Scripts Copay

Retail: $0 copay

Home delivery: $0 copay

For details on what is considered “preventive care,” contact Express Scripts.

Generic

Retail: 20% of the cost; minimum $5 copay and $40 maximum (up to a 30-day supply)

Home delivery: $10 copay (31- to 90-day supply)

Scripts

Preferred Brand Name

Express

Retail: 20% of the cost; minimum $15 copay and $40 maximum (up to a 30-day supply)

Home delivery: $30 copay (31- to 90-day supply)

Non-Preferred Brand Name

Retail: 20% of the cost; minimum $30 copay and $40 maximum (up to a 30-day supply)

Home delivery: $50 copay (31- to 90-day supply)

What you need to do

  • Use retail network pharmacies
  • Use mail order or a Walgreens retail pharmacy to fill a 31- to90-day prescription

To find a retail network pharmacy, or to get started with home delivery, visit Express Scripts or call 866-830-3890 during business hours.

Costs

Find your TRICARE costs, including copayments,
enrollment fees, and payment options.
  • Most costs are for calendar year 2021 unless noted separately.
  • For US Family Health Plan and TRICARE Prime Remote costs, choose 'TRICARE Prime' from the pull-down menu
  • Visit the Cost Terms page for definitions to help you better understand TRICARE costs.
  • If you're an unremarried former spouse, for the Continued Health Care Benefit Program (CHCBP), chose 'Retired' regardless of your sponsor's status
  • Looking for dental costs? Visit the TRICARE Dental Costs section.

Express Scripts Copay For Creon

When did the sponsor enlist in or was appointed to the uniformed services?

Express Scripts Copay Amounts

Copayments will be waived retroactively to March 18 for certain testing and office visits related to the testing. The test must be one approved, cleared, or authorized by the Food and Drug Administration to detect SARS-CoV-2 or diagnose COVID-19. If you paid any copayments for testing related to COVID-19 and the resulting office visits with a network or non- network provider, you may file a claim for reimbursement. For more information related to the coronavirus, visit the FAQ page.