Prescription Drug Benefits


Prescription drug benefits are included in the BJC Medical Plan option that you elect. Present your Cigna insurance card when purchasing medications.

Prescription Drug Coverage Chart

 

BJC or Select
Out-of-Area Pharmacy

Express Scripts
Pharmacies
(Walgreens)

 

BJC Employee Pharmacy
(Mail-Order only)

Up tp 30-Day-Supply
1st Fills Only (MO & IL)

 30-Day / 90-Day supply
1st Fills & Refills
(MO & OL)

Generic Drugs

$10

$25

$10 / $25

Preferred
Brand-Name Drugs

$30

$75

$30 / $75

Non-Preferred
Brand-Name Drugs

$75

$150

$75 / $150

Specialty Drugs

 

See details regarding All Specialty Drug coverage below.

 

Annual Out-of-Pocket Maximum

Per Individual

$2,000

Per Individual

$4,000


Copayments

Prescription drug copayments depend on the type of pharmacy you choose and the type of drug you purchase and the supply amount. Copayments for the above listed 90-day supplies apply only to maintenance medications.

Note: 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.

Benefit Features:

  • Prescription drug claims are administered by Express Scripts
  • You will pay the lowest copayment when filling NEW prescriptions (first fills) at any BJC pharmacy, including the BJC Employee Pharmacy (mail-order). New prescriptions filled at Walgreens will be subject to a higher copayment
  • All REFILLS in Missouri and Illinois need to be filled through the BJC Employee Pharmacy (mail-order) to obtain the lowest possible copayment. Refills not processed through the BJC Employee Pharmacy (mail-order) will result in significantly higher costs to you
  • All Specialty Drugs (first fills and refills) need to be directed to the BJC Employee Pharmacy (mail-order). Copayment is $50 if filled through the BJC Employee Pharmacy (mail-order) or $100 if filled through Walgreens..

Eligible 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 (average delivery time may be shorter).
  • BJC Pharmacies include six pharmacies that are located within BJC facilities, plus the BJC Employee Pharmacy (mail-order).
  • Express Scripts Pharmacies are exclusively Walgreens. 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.  

Details about prescription drug benefits, including mail-order service, how to fill prescriptions, prescription drug lists (maintenance, specialty) can be found on the Total Rewards website.

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St. Louis, Missouri 63108
314.286.2000
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