PPO & EPO Pharmacy Information

There are no changes to the 2019 PPO & EPO Pharmacy Benefits for 2020. However, Express Scripts does update their formulary annually effective January 1, 2020.

 

                           2020 Express Scripts Perferred Formulary 

                                     2020 Pharmacy Exclusions 

                           2019 Express Scripts Preferred Formulary

                              2019 PPO Pharmacy Plan Document

                               2019 EPO Pharmacy Plan Document

 

Anthem Care PPO, Anthem Choice, Anthem Select & Anthem EPO

When Picking Up From an In-Network Retail Pharmacy

Annual Out-of-Pocket Limit

$2,000 individual / $4,000 family

Generic

$5 copay

Preferred Brand

$20 copay

Non-preferred Brand

$50 copay

Supply 

30 days

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.

                                                               Anthem Care PPO, Anthem Choice, Anthem Select & Anthem EPO                                                                  

When Receiving a 3-Month Supply Through Mail Order

Annual Out-of-Pocket Limit

$1,000 Mail Order

Generic

$10 copay

Preferred Brand

$40 copay

Non-preferred Brand

$100 copay

Compound Drug

N/A

Supply

100 days

 

                                                Express Scripts Contact Information 

 Service

                            Phone     Number

 Member Customer Service

1-877-554-3091        

 Specialty Pharmacy Inquiries 

1-877-248-1164

 Retail Pharmacy Help Desk (For pharmacists to call   if they are having issues running your insurance)

1-800-922-1557

 Coverage Review Department (For your provider  to call regarding prescriptions needing prior                authorization)

1-844-374-7377