Prescription Drug Benefits


Prescription drug benefits are included in the BJC Medical Plan option that you elect. Present your Cigna medical ID card when purchasing medications. Key benefits include:

  • Prescription drug claims are administered by Express Scripts, BJC’s prescription drug benefits manager.
  • When filling NEW prescriptions (First Fills) using any BJC Pharmacy, the BJC Employee Pharmacy (mail order) or any Select Out-of-Area Pharmacy, you will pay the lowest copayment. New prescriptions filled at a Walgreens pharmacy will be subject to a higher copayment.
  • All REFILLS in Missouri and Illinois need to be filled through the BJC Employee Pharmacy mail-order service in order to obtain the lowest possible copayment. Refills not processed through the BJC Employee Pharmacy (mail order) will have a higher copayment.
  • All prescriptions for Specialty Drugs need to be directed to the BJC Employee Pharmacy mail-order service. This includes new prescriptions (first fills) and refills for Specialty Drugs. Prescriptions not processed through the BJC Employee Pharmacy will have a higher copayment.

Prescription Drug Coverage Chart

Types of Pharmacies 

  • BJC Employee Pharmacy (mail order) can deliver 30-day first fills (new prescriptions), refills and 90-day supplies of maintenance medications, and all specialty drug prescriptions with no mailing or handling fees. Employees should order 10 business days in advance (though average delivery time may be shorter).
  • BJC Pharmacies include six pharmacies that are located within BJC facilities, plus the BJC Employee Pharmacy (mail order).
  • Select Out-of-Area Pharmacies are designated in specific geographic areas for BJC employees who do not have easy access to BJC pharmacies.
  • Express Scripts Pharmacies for 2018 will be exclusively Walgreens and its affiliated pharmacies. Walgreens operates 8,175 drugstores with a presence in all 50 states. 

Types of Drugs

  • Generic Drugs offer the same level of quality, safety, and effectiveness as their brand name equivalents; but at lower prices.
  • Preferred Brand-Name Drugs cost more than generic but less than non-preferred brand name drugs; ask your doctor if a generic substitution is available.
  • Non-Preferred Brand Name Drugs cost more than preferred brand-name drugs and are often used to treat complex medical conditions; ask your doctor if a generic or preferred brand-name “equivalent drug” is available.
  • Specialty Drugs cost the most and can require special handling, administration or monitoring. They are used to treat complex and chronic conditions, such as multiple sclerosis, rheumatoid arthritis, hepatitis C and hemophilia. All Specialty Drug prescriptions must be directed to the BJC Employee Pharmacy mail order.  

Copayments

Prescription drug copayments depend on the type of pharmacy you choose and the type of drug you purchase. Please know that each BJC Medical Plan participant is allowed two emergency fills per calendar year (from a list of eligible drugs) at Walgreens, and at the same copayment as BJC pharmacies.

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