Prescriptions for Non-Medicare Members

The Relief PPO Medical Plan Prescription Drug benefits are provided through Express Scripts (formally known as Medco). 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 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.


(Visit for a list of approved pharmacies in your area.)


For instructions on how to start your Mail-Order Prescription program, visit 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.

As of January 1, 2015, plan options changed for members enrolled in the PPO Plan. If you are on Medicare, click here. All others, including family members who are not Medicare-eligible, click here.

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