PRESCRIPTION PLAN
Express Scripts
Prescription benefits are part of the Medical Plan. Prescriptions are available through a participating Pharmacy or through Home Delivery service.
| Participating Pharmacy | Home Delivery | ||||||
|---|---|---|---|---|---|---|---|
| Generic | Formulary | Non-Formulary | Generic | Formulary | Non-Formulary | ||
| Co-insurance | 20% | 30% | 40% | $15 | $30 | $70 | |
| Minimum | $8 | $25 | $45 | n/a | n/a | n/a | |
| Maximum | $22 | $45 | $85 | n/a | n/a | n/a | |
| *Note: Participating Pharmacies will dipsense up to a 34-consecutive day supply |
*Note: Home Delivery will dispense up to a 90-consecutive day supply |
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Information on Medicare Part D Coverage for all Medicare Eligible Employees:
Medicare requires all employers that offer prescription plan coverage to send all Medicare eligible participants an annual notice to inform them if the prescription plan is creditable. Creditable means that the employer sponsored plan is at least as good as the coverage offered through Medicare Part D.
Notice of Creditable Coverage(english/spanish) may be printed and provided to Social Security.
Express Scripts Summary Plan Description
Express Scripts National Preferred Formulary for the State of NM
- Benefit Services
- MSC 3HRS * P.O. Box 30001 * Las Cruces, NM 88003 * Hadley Hall, Room 14
- (505) 646-1741 * benefits@nmsu.edu