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Virtual Benefits Fair is September 29 – October 6. Open Enrollment is October 1 - 15
This service provides information and resources for Pharmacy benefits.
New! Rx 'n Go Pharmacy Benefit
Retail Pharmacy Help Desk (For pharmacists to call if they are having issues running your insurance)
Coverage Review Department (For your provider to call regarding prescriptions needing prior authorization)
To create an account with Express Scripts please visit www.express-scripts.com. You can manage your prescriptions, set up mail order, view the latest formulary, price a medication, print your ID card, and so much more.
Participating Pharmacies (SB & SLO County)
Express Scripts Preferred Formulary
2019 PPO Pharmacy Plan Document
2019 EPO Pharmacy Plan Document
All employees, excluding those enrolled in the HDHP, will now have the same pharmacy benefit. This change will reduce out of pocket maximum for those enrolled in the Anthem EPO plan.
You could possibly save money switching to mail order over picking up at a retail pharmacy if you are on any maintenance medications. Your co-pay for a 1-month supply of a generic medication at a pharmacy is $5 or you can get the same medication, but a 3 month supply, for a $10 co-pay through mail order. Log on to your online Express Scripts account for more information.
IngenioRx will be Anthem's new Pharmacy Benefit Manager (PBM) effective July 1, 2019. The mail order pharmacy and specialty pharmacy will change for members. Some members may need to change pharmacies. Most major pharmacies are included, but some smaller pharmacies are not.
Members with active mail order scripts will be reported to the PBM, but payment information will not move over. Additionally controlled substances and compound medications will not transfer over. Members will need to receive a new prescription to fill these medications. All Rx prior authorizations will transfer automatically unless they are expired.
You pay 100% of pharmacy costs until you meet the plan’s deductible. This means if your prescription costs $100, you will need to pay the $100 each time you pick it up until you reach your deductible. You do NOT have a set co-pay. Once you meet your deductible, you will have co-insurance coverage, meaning you will pay 20% of your prescription’s cost. If your prescription costs $100 and you have met your deductible, you will pay 20% ($20) and the plan will cover the remaining 80% ($80). Once you reach your annual out-of-pocket maximum, the plan will pay 100%.