Prescription Drugs
When you enroll in any Veolia medical plan, prescription drug coverage through Express Scripts is automatically included. Your prescription drug benefits will vary depending on which medical plan option you choose, the type of medication you are prescribed and whether you get it filled using a participating retail pharmacy or by home delivery. Certain preventive medications are also covered at 100%, as required by the Affordable Care Act (ACA).
Click HERE for a list of preventative medications in 2024
Click HERE for a list of preventative medications in 2023
Don’t have your prescription ID card?
You can view your digital prescription ID card on your mobile device using the Express Scripts® mobile app or print your ID card from express-scripts.com. Click Here
Comparison of Prescription Coverage through Medical Plans:
- 2024 Prescription Coverage Comparison
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Prescription Drugs |
High Deductible Health Plan – Silver* and Gold* |
PPO / EPO Plans |
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For retail (30-day supply), you pay: |
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Generic: Brand: Non-formulary: |
20%, min: none / max: $100 after deductible 30%, min: none / max: $100 after deductible 40%, min: none / max: $100 after deductible |
$10 copay 25% (min $30, max $75) 35% (min $50, max $110) |
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Maintenance medications: |
Your plan allows coverage for two 30-day fills of your long-term medications at any network pharmacy. After that, you will be required to fill your maintenance medications in 90-day supplies from Express-Scripts Home Delivery. |
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For home delivery (90-day supply), you pay): |
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Generic: Brand: Non-formulary: |
20%, min: none / max: $200 after deductible 30%, min: none / max: $200 after deductible 40%, min: none / max: $200 after deductible |
$25 copay 25% (min $75, max $150) 35% (min $125, max $225) |
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*If enrolled in the High Deductible Health Plans (Gold and Silver), you will pay full price for prescriptions (except Preventative medications on the ACA or ESI preventative drug list, or those listed medications prescribed for chronic conditions), until you meet your medical deductible. |
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Express Scripts Formulary List and Exclusions:
Consumer-Driven Healthcare (CDH) Preventative Medications:
Notice of Creditable Coverage:
The prescription drug program provided by the medical plan options offered by Veolia North America is considered Creditable Coverage, meaning on average the coverage is at least as good as standard Medicare prescription drug coverage. You can find the notice at the end of your Benefits Enrollment Guide.
Maintenance Medication Home Delivery:
If you take a maintenance medication, such as those used to treat high blood pressure or high cholesterol, you’ll need to make an important decision on where you fill that prescription. At a retail pharmacy, you’ll pay the entire cost for a maintenance medication after the second purchase if you do not have that prescription filled through home delivery. To avoid higher costs, take advantage of the home delivery pharmacy services from Express Scripts. To learn more about how to use the Express Scripts pharmacy for home delivery, click HERE.
Advanced Utilization Management Programs:
The Advanced Utilization Management (AUM) programs help you choose the safest, most cost-effective drug and ensure that your use of the drug meets FDA guidelines. Prior authorization ensures clinically appropriate use of medications, click HERE. Step therapy encourages use of clinically effective, lower cost generic and preferred brand alternatives before higher cost medications. Drug quantity management aligns dispensing quantity with FDA-approved dosage guidelines and other supportive evidence.
Supplemental Prescription Drug Program:
When your medical plan doesn’t cover a prescription, Express Scripts can often fill it outside of the plan at a discounted price. You will pay 100% of the discounted price; any amount you pay won’t apply to your plan’s deductible or maximum out-of-pocket costs since the coverage is outside of the plan. Send your valid prescription to the Express Scripts Pharmacy through mail order or deliver the script to a retail pharmacy like you do today for covered drugs, and ESI will process it at a discount.
Registering with Express Scripts and Pricing Medications:
To learn how to register online with Express Scripts, click HERE.
To learn how to price medications, click HERE.
Have More Questions?
Please contact Express Scripts Customer Service at (888) 792-7276 or online at express-scripts.com.