Express Scripts Medicare™ (PDP) is a Medicare-approved Part D plan that is available nationwide and in Puerto Rico. Express Scripts Medicare offers two plans to suit your individual needs:
- The Value plan is our national plan, which features a low monthly premium and $4 Preferred Generic Drugs (Tier 1) at retail network pharmacies. This plan is available in all 50 states plus the District of Columbia and Puerto Rico.
- The Choice plan features low generic drug copayments through the Coverage Gap, and $0 Generic Drugs (Tier 1) when you use mail order from the Express Scripts family of pharmacies. This plan is available in 31 states plus Puerto Rico.*
When you enroll in Express Scripts Medicare, you get access to:
- Express Scripts Medicare Advisors who are available 24/7 to answer your questions, offer ways to help you save on the drugs you depend on, and suggest ways to delay entering the Coverage Gap stage.
- Pharmacists who watch out for your health and safety, and who are specially trained in the medications used to treat a specific condition. They're always available by phone to answer your questions - even in the middle of the night.
- More than 3,000 of the most commonly prescribed prescription drugs.
- Your choice of pharmacies, with a national network of more than 64,000 pharmacies, including large chains, independent drug stores, and convenient mail order from the Express Scripts family of pharmacies.
*The Choice plan is not available in the following areas: AR, CT, DC, DE, ID, LA, MA, MD, MO, NC, NJ, NY, OK, OR, RI, SC, UT, VA, VT, WA.
If you have Medicare and full Medicaid coverage: The Centers for Medicare & Medicaid Services (CMS) automatically enrolls you in a Medicare prescription drug plan each year if you meet the following criteria:
- You are a full benefit dual-eligible (meaning you have both Medicare and Medicaid), are a Medicare Savings Program participant, or receive Supplemental Security Income (SSI); OR you applied and were approved for low-income subsidy help.
- You have been automatically enrolled into a Medicare prescription drug plan in the past and you continue to receive low-income subsidy help in 2013.
- You or your authorized representative did not voluntarily choose to enroll in another prescription drug plan.
- Your current prescription drug plan has a premium in 2012 that is above the minimum amount required by CMS, or your Medicare prescription drug plan is terminating at the end of 2012.
If you were automatically enrolled in a plan other than Express Scripts Medicare, you are allowed to switch to Express Scripts Medicare if you choose to, but you will be responsible for paying any additional costs.
Please note that if you currently have prescription coverage through another plan, you may not need to join Express Scripts Medicare. You should speak to a representative who handles your current prescription benefit before making the decision to enroll. You cannot enroll in this program if your current or former employer helps you pay for your drugs.
Need help finding the best option?
Call Customer Service toll-free at 1-866-477-5703, 24 hours a day, 7 days a week (except Thanksgiving and Christmas). Customer Service is available in English and other languages. TTY users call 1-800-716-3231.
If you're interested in learning more about Express Scripts Medicare, visit www.Express-ScriptsMedicare.com.
The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year.
This page was last updated on 10/01/2012.
A Medicare-approved Part D sponsor