Prescription Drug Coverage

As a member of the Boston University Health Plan, you will automatically be enrolled in the Express Scripts Prescription Drug Coverage.

Special Note For members of the BU Health Savings Plan (the high-deductible health plan)

You must meet your annual in-network health plan deductible before you have any coverage for prescription drugs.  Once you meet your health plan deductible, you pay 10% coinsurance for your prescriptions. The copayments and coinsurance listed below do not apply.

For members of the BCBS PPO and Network Blue New England Plans

Prescription copayments vary depending on whether your prescribed medication is a generic, preferred brand-name, or nonpreferred brand-name drug. (Preferred brand-name medications are selected based on their clinical effectiveness and opportunities for savings). An independent Pharmacy and Therapeutics Committee updates this list regularly based on continuous evaluation of medications.

Members can determine whether their brand-name medications are preferred or non-preferred by logging into the Express Scripts website and choosing the Drug Information option.

There is a 20% coinsurance for preferred brand-name drugs with a minimum  cost of $30 and a maximum cost of $50 for up to a 30-day supply at a retail pharmacy.

If your prescription is a nonpreferred brand-name drug, your 30% coinsurance will have a minimum cost of $50 and a maximum cost of $70 for up to a 30-day supply at a retail pharmacy.

Many preferred and nonpreferred brand-name drugs have a generic alternative. If you use the generic drug, your copayment will be $8 for up to a 30-day supply at a retail pharmacy.

Certain medications have quantity and/or dollar limits. Please view the Express Scripts Member Brochure for details.

Prior Authorization — The plan covers medically necessary prescription medication. Some drugs require prior authorization in order to be covered by the plan. Visit the Express Scripts website and click on “Drug Information” to find out about a specific medication.

Retail Pharmacy — If you need short-term medication (perhaps for the flu or an ear infection), under the Retail Network Pharmacy Service you can take your prescription to almost any major chain (CVS, Walgreens, Wal-Mart, Costco, Rite-Aid, Osco, etc.) and many independent pharmacies, show your ID card, pay your co-payment, and go home with your prescription.

Type of Medication Up to a 30-Day Supply
Generic drugs $8 copayment
Preferred brand-name drugs 20% coinsurance
with a minimum cost of $30 and a maximum cost of $50
Nonpreferred brand-name drugs 30% coinsurance
with a minimum cost of $50 and a maximum cost of $70

Home Delivery Pharmacy Service — If you take medication for a chronic condition, such as diabetes or asthma, you can get a prescription from your doctor for up to a 90-day supply plus refills for the rest of the year, and then order your medication through the Home Delivery Pharmacy Service. You can place your order by mail, online, over the phone, or by having your physician fax the prescription to Express Scripts. There are no shipping costs unless you request express shipping. Regular mail takes 7–11 days from the date you place your order; it’s faster if you order by phone, internet, or fax. A refill slip, including the date you can order the next refill, will come with every order. It’s safe, easy, and the lowest cost way to purchase your medication.

Type of Medication Up to a 90-Day Supply
Generic drugs $16 copayment
Preferred brand-name drugs 20% coinsurance
with a minimum cost of $60 and a maximum cost of $100
Nonpreferred brand-name drugs 30% coinsurance
with a minimum cost of $100 and a maximum cost of $140

Contact Information

  • Express Scripts website
    Customer Service: 1-800-230-0508
  • To refill a Home Delivery Pharmacy Service using the automated system: 1-800-4REFILL (1-800-473-3455)