Express Scripts National Preferred Formulary
Under your prescription drug plan, your medication may be a brand name or a generic alternative. Your prescription drug plan also includes a formulary. At its most basic level, formularies are lists of drugs, generic and brand name, which offer the greatest overall value to plan participants. The Plan’s Formulary is provided by your Pharmacy Benefits Manager (PBM), Express Scripts Inc. (ESI).
Medications indicated on the formulary list are typically grouped into three tiers: generic, preferred brand and non-preferred brand. Formulary management enables you and your physician to choose clinically appropriate and cost-effective drugs for specific conditions. Medications not on the formulary list are not covered by the Plan.
Click here to watch a video on how formularies work.
Below is the Plan's 2018 Preferred Formulary, including the most common generic and preferred drugs. This list is not all-inclusive and does not guarantee coverage as it is subject to change.
Out of more than 4,000 prescription drugs available on the market, Express Scripts National Preferred Formulary excludes less than 200 prescription drugs. For each one of those excluded drugs, there are clinically equivalent, lower-cost options available. In most cases, if you fill a prescription for one of these excluded drugs, you will pay the full retail price. The plan's formulary will continue to ensure that clinically sound, cost-effective drugs are available to members and will drive greater savings, in part by minimizing brand inflation and by reducing the use of non-preferred brands. Click here
for a full list of exclusions.
To check the price and coverage of medications under your plan simply select “My Prescription Drugs” then “Price a medication” from the menu and search for your medication to see pricing. Click “View coverage notes” on the pricing results page to see any coverage details.
If a medication is non-preferred, coverage notes will display "This medication is covered under your plan; however, it is a non-preferred product."
and if the medication is excluded, coverage notes will display "This medication is no longer covered on your drug list; view preferred alternatives".
You can click the link to "view formulary alternatives."
Take action to avoid paying full price.
If you’re currently using one of the non-preferred or excluded medications, please ask your doctor to consider writing you a new prescription for a preferred alternatives.
Only members of the following trust(s) may view the full details of this program:
If you are a member of one of these trusts, please login or register for more information.