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 medications in 2021.
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.
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.
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.
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.
To learn how to register online with Express Scripts, click HERE.
To learn how to price medications, click HERE.
Please contact Express Scripts Customer Service at (888) 792-7276 or online at express-scripts.com.