Prescription Drug Coverage
As a member of the Boston University Health Plan, you will automatically be enrolled in prescription drug coverage through 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 will pay a 10% coinsurance for your prescriptions. The co-payments and coinsurance listed below do not apply. The annual out-of-pocket maximum for health and prescription drugs is combined.
For Members of the BCBS PPO and Network Blue New England Plans
Prescription co-payments vary depending on whether your prescribed medication is a generic, preferred brand-name, or non-preferred 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 non-preferred 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 non-preferred brand-name drugs have a generic alternative. If you use the generic prescription drug, your copayment will be $8 for up to a 30-day supply at a retail pharmacy.
The annual out-of-pocket maximum for prescription drugs of $2,000 for individual coverage and $4,000 for family coverage is separate from that of the medical out-of-pocket maximum for these two health plan options.
The plan covers medically necessary prescription medication. Some drugs require prior authorization in order to be covered by the plan. To learn about a specific medication, Visit the Express Scripts website and click on Drug Information.
When you need short-term medication (e.g., for the flu or an ear infection), with the Retail Network Pharmacy Service you can take your prescription to almost any major pharmacy chain (CVS, Walgreens, Wal-Mart, Costco, Rite Aid, Osco, etc.) and many independent pharmacies. Simply show your ID card and pay your co-payment.
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|
|Non-preferred 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. Orders may be placed 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. Note that 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 least expensive 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|
|Non-preferred brand-name drugs||30% coinsurance with a minimum cost of $100 and a maximum cost of $140|
Customer Service: 1-800-230-0508
To refill a Home Delivery Pharmacy Service prescription using the automated system: 1-800-4REFILL (1-800-473-3455)