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Prescriptions for Non-Medicare Members

The Relief PPO Medical Plan Prescription Drug benefits are provided through Express Scripts. For short-term medications, fill your prescription at your local retail pharmacy. The amount of your copay for a 30-day supply will vary depending on whether you are requesting Generic versus Single-Source Brand or Multisource Brand (brand when a generic is available) name drugs.

Long-term or maintenance medications, should be filled through Express Scripts Mail Order or through Walgreen’s retail pharmacies. Filling your maintenance medications through Mail Order or Walgreen’s allows you to get up to a 90-day supply. You will be charged an additional $50 copay per prescription filled at a non-Walgreen’s retail pharmacy after the third fill if the drug is available through Mail Order.

Click here to download the Express Scripts prescriptions home delivery (mail) order form. Instructions are on the form.

NON-MEDICARE-HEADER

(Visit Express-Scripts.com for a list of approved pharmacies in your area.)

For instructions on how to start your Mail-Order Prescription program, visit Express-Scripts.com or call (800) 711-0917.

If you do not obtain your prescription drugs at a participating Express Scripts pharmacy, you must pay the full price of your prescriptions at the time of purchase and submit a claim directly to Express Scripts for reimbursement. Express Scripts will reimburse you 100% of the discounted price of the cost of each prescription, less the copay.

The Express Scripts Mobile App lets you access and manage your prescriptions while you are on-the-go. You can download the Express Scripts Mobile App for free from your device’s app store: iTunes, Google Play, Windows Phone Store and BlackBerry App World. Search for “Express Scripts” and download it today. To learn more, please visit Express-Scripts.com/mobileapp.

Specialty Medications

Specialty medications are used to treat complex and chronic conditions such as cancer, chronic kidney failure, multiple sclerosis and rheumatoid arthritis. Oftentimes, specialty medications require special handling, administration or monitoring.

Most specialty medications are covered through Accredo (Express Script’s specialty pharmacy). To find out if your specialty medications need to be ordered through Accredo, call Express Scripts at (800) 711-0917.

Your copays for specialty medications are the same copays noted on the prior page, with a maximum copay amount of $200 instead of $300. Note that most specialty medications will be dispensed in a 30-day supply amount.

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Main Office Numbers
(800) 244-3439 Toll-free
(323) 259-5200 Direct

Office Location
7470 N. Figueroa St
Los Angeles, CA 90041

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