Health / Pharmacy | Prescription Drug Benefits (2024)

Prescription drug benefits are included in the BJC Medical option that you elect and Express Scripts administersour coverage. Present your Cigna ID card when purchasing medications.

You may use BJC pharmacies or any pharmacy in the Walgreens National network to fill and refill your 30-day and 90-day prescriptions.

To begin using BJC's pharmacymail-order service, we encourage BJC Medical Plan participants and covered dependents over 18 to visit pharmacy's website, www.BJCRx.org. From there, you can:

• Order prescriptions
• Transfer prescriptions
• Check prescription status
• Manage your account: payment, dependents, contact information

Prescription Drug Coverage Chart - Signature or Flex option*

*If you are outside of MO or IL, use a Walgreens National Network pharmacy for all non-specialty prescriptions.

**All specialty medications must be directed to the BJC Family Care Central Pharmacy (mail-order).

Note: the annual out-of-pocket maximums for prescription drugs in the Flex and Signature options are separate from the medical plan out-of-pocket maximum.

Prescription Drug Coverage Chart - High-Deductible Health Plan (HDHP)with HSA*

*If you are outside of MO or IL, use a Walgreens National Network pharmacy for all non-specialty prescriptions.

**All specialty medications must be directed to the BJC Family Care Central Pharmacy (mail-order).

Note: the deductible and coinsurance amounts for both medical and prescriptions drugs are combined into one out-of-pocket maximum.

Copayments

The amount you pay depends on your medical option, the pharmacy you choose, the type of drug you purchase and the supply amount. Prescriptions are usually written for 30 days or 90 days.

Visit www.express-scripts.com/BJC to price a medication before filling a prescription.

In the Signature and Flex options, prescription drugs are subject to a copay (except for eligible preventive medications, which are covered at 100%).

In the HDHP option, you pay the full cost of prescription drugs (except for eligible preventive medications, which are covered at 100%) until you meet your deductible. Once you satisfy the deductible, the plan will begin sharing the cost with you. You can use your Health Savings Account (HSA) to pay for prescription drug expenses.

BJC uses a program to reduce member copay to zero on eligible specialty drugs (SaveonSP). The Family Care Central Pharmacy will notify you when this is applicable.

Eligible Pharmacies

• BJC Family Care Central Pharmacy(mail-order) can deliver 30-day first fills, refills, 90-day supplies of maintenance medications, and specialty drug prescriptions to your home with no mailingfees. Employees should order 14days in advance (average delivery time may be shorter).
• BJC Pharmacies (in person) can fill and refill 30-day and 90-day prescriptions; includes fivepharmacies located within BJC facilities.
• Walgreens(in person) can fill and refill 30-day and 90-day prescriptions; availablein all 50 states.
• Visit www.express-scripts.com/BJC to locate a network pharmacy.

• Prescriptions are usually written for 30 days or 90 days.
• For new prescriptions, the first fill (except for specialty medications) can be cared for in any of our eligible pharmacies (in person or mail-order).
• The BJC plan only covers prescriptions filled at our eligible pharmacies. You will pay the full cost of your medication if you go out of our network.
• To pay the lowest copay, employees should use a BJC pharmacy (picking up at Walgreens will have a higher copay).
• Refills(30-day or 90-day) in Missouri and Illinois* can be filled by BJC Family Care Central Pharmacy (mail-order).
• Specialty medicationsmust be filled by BJC Family Care Central Pharmacy (mail-order).
• To use BJCmail-order, you and each of your covered dependents must first create an account onwww.BJCRx.organd then transfer your current prescriptions. If you need assistance, call the BJC Family Care Central Pharmacy at 314-657-9000 or 855-525-0411, 8 a.m. - 4:30 p.m., Monday - Friday.
• Place your mail-order request 14 days in advance so you do not run out of your medication.
• Prescriptions filled through the mail-order pharmacy will be delivered to your home address.
• Certain medications and dosages may trigger the need for authorization. Your physician will be contacted, and authorization must be received before your prescription is filled.
• Use your Cigna card to obtain prescription drugs. Pharmacy information, administered by Express Scripts, is on the back side of the card.

*If you reside outside of Missouri or Illinois, you should utilize a Walgreens network pharmacy for all non-specialty prescriptions. The Walgreens copay will apply on all new and refill prescriptions.

Transfers

• Transfer from one BJC pharmacy to another BJC pharmacy: call the pharmacy where you want the prescription filled. Use the automated phone system and follow the prompts to place your refill request.Find pharmacy phone numbers here. You may also go to www.BJCRx.org. The automated phone system cannot be used for transfer of controlled substances (CIII-V).
• Transfer from a non-BJC pharmacy to a BJC-pharmacy: go towww.BJCRx.org, then go to Transfer Prescriptions. (If you have not created an account on BJCRx.org, it is recommended that you do so). Or you may call the pharmacy where you want the prescription filled.Find pharmacy phone numbers here.

To begin using BJC's pharmacy benefit, including mail-order, we encourage BJC Medical Plan participants and covered dependents over 18 to visit pharmacy's websitewww.BJCRx.organd create an account.

Filling a mail-order prescription

Only BJC employees and their dependents who are BJC Medical Plan participants and receive mail in Missouri or Illinois can use mail-order from Family Care Central Pharmacy.

Refills should be requested 14 days prior to your current supply running out.Do not use mail-order if your prescription is an urgent-need medication, such as an antibiotic.

The Family Care Central Pharmacycan fill up to a 90-day supply of certain medications. Ask your physician to write the prescription for 90 days.

To fill a prescription using Family Care Central Pharmacy (mail-order):

Option 1: Ask your physician to electronically submit a prescription to the Family Care Central Pharmacy. The pharmacy can receive all prescriptions, including controlled substances, through the SureScripts network used by physicians. Provide the pharmacy phone number to your physician, 314.657.9000 (do not give the physician the toll-free number).

Option 2: Your physician can fax the prescription to the Family Care Central Pharmacy, 314.525.0416. The pharmacy cannot accept prescriptions faxed by the Plan Member.

Option 3: The Plan Member can mail the original paper prescription to:

Family Care Central Pharmacy
1234 South Kingshighway Blvd., Suite 1500
St. Louis, MO 63110

Frequently Asked Questions