Pharmacy Benefit Plans - Ask The Pharmacist

Jan 28, 2013
Have a new pharmacy benefit this year? Express Scripts pharmacist Paul Reyes provides tips for understanding your benefit and getting more value out of it.
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For many Americans, a new year means changes to your pharmacy benefit plan. I counsel my patients to read their new benefit plan materials carefully so they understand what’s new and different, and don’t encounter delays when they need to fill a prescription. Your employer or benefit provider may have changed your copayment structure, your formulary (list of covered medications) or added requirements about where you can fill your medications.

A thorough review of your benefit details can help you save money and make the most of your benefit. For many people, the pharmacy benefit is provided by a pharmacy benefit manager, such as Express Scripts. It’s our job to make sure patients get the medications they need safely and quickly at the lowest cost possible, and to offer clinical support and assistance with their medication regimen.

Make the Most of Your Pharmacy Benefit

Here are some ways you can maximize your pharmacy benefit:

Home delivery is a safe and convenient way to obtain prescription medications that you use consistently. Many pharmacy plans will provide you with up to a 90-day supply of your medication for a lower copayment, which can reduce your prescription costs significantly. Be sure to tell your doctor that you use home delivery so your prescription is written for a 90-day supply.

Preferred pharmacies offer lower copayments when you use a retail pharmacy that is in your preferred network. Most networks are broad and offer many convenient options. To achieve optimal savings, make sure your pharmacy is in the network before you fill. And inform your doctor, as he or she may now send electronic prescriptions directly to the pharmacy.

Generics provide patients with a great opportunity to save money. Many plans offer significantly reduced copayments when you use a generic – and some may even charge you a penalty if you choose a brand when a generic equivalent is available. This year, 16 popular medications will become available as a generic, so regularly review your medications with your doctor or pharmacist and ask “is there a generic for that?

Express Scripts pharmacists, like me, work behind the scenes to keep patients safe and healthy, and we are available 24 hours a day to answer questions from the privacy of your home. We can review your total prescription history – and in some cases, your medical and lab histories – to provide comprehensive care and counseling. At Express Scripts, we also have pharmacists that specialize in different diseases to provide patients with conditions such as asthma, diabetes, cancer and heart disease with a greater level of support and care.

Adherence to your medication regimen is truly the best way to make sure you get the most from your pharmacy benefit. Take your medication at the proper time and frequency as indicated by your doctor, and refill and renew prescriptions as early as possible so you are never empty-handed. At Express Scripts, we offer mobile apps, as well as auto-refill and renewal reminder programs to help you stay on track.

Express Scripts is a valuable resource that can keep you safe and healthy, and help keep your medication costs down. Spending a little time getting to know us can yield big rewards for you and your family.

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