Express Scripts

Express Scripts program coordinates with following medical plans:

  • Blue Shield Tandem PPO
  • Blue Shield Choice PPO
  • Blue Shield Care PPO
  • Blue Shield EPO

For retirees enrolled in Medicare, Express Scripts coordinates with the following medical plans:

  • Blue Shield EPO Medicare
  • Blue Shield PPO Medicare

You can conveniently fill maintenance medications (drugs you take regularly for ongoing conditions) up to a 90-day supply through home delivery or at a retail pharmacy in the Smart90 network, either CVS or Walgreens! After the third time you purchase up to a 30-day supply of a maintenance medication at a pharmacy, you’ll pay a higher cost under your plan. By choosing a 90-day option—either through home delivery or at a Smart90 pharmacy—you can avoid this higher cost. You will pay the same copayment for your 90-day supply with either option. 

Throughout the year, Express Scripts asks an independent panel of doctors and pharmacists to review and compare all of the medications available to patients. When the panel finds there are multiple medicines that work to treat the same condition and are equally as safe, the findings results into formulary changes each year on 7/1 and 1/1. If your prescription is impacted, Express Scripts will contact you directly via phone and mail. 

For details on pharmacy costs, please visit the Employee Benefits Brochure

For FREE maintenance medications, please visit the Rx ‘n Go site.

Contact Information

Customer Service- (Non-Medicare) 1-877-554-3091

Customer Service (Medicare) 1-844-468-0428

Pharmacy Inquiries- 1-877-248-1164

Coverage Review- 1-844-374-7377

Specialty Pharmacy Inquiries  1-877-248-1164

Retail Pharmacy Help Desk (For pharmacists to call if they are having issues running your insurance) 1-800-922-1557

https://www.express-scripts.com/

FAQs

You can get free prescription maintenance medication through Rx ‘n Go. Please visit the Rx N Go webpage to learn more.

Please view the benefits brochure to get a breakdown of cost for prescriptions, or login to your account at Express Scripts website.

If you do not have your pharmacy ID card or if your pharmacy asks for the PCN, make sure to let the pharmacy know that your pharmacy benefit manager (PBM) is Express Scripts. 

If your pharmacist enters a claim and it is denied, they will receive a rejection message requesting they enter a value in the PCN field. Pharmacists are prompted to enter PEU when receiving this message. If the pharmacist misses this message, then they can call the Pharmacy Help Desk number on the back of your pharmacy ID card: (800) 922-1557

For additional support, contact Accolade at (866) 406-1275.

Reference

2024 Express Scripts Comprehensive National Preferred Formulary
2024 National Preferred Formulary Exclusions List Changes 01-01-24
County of SLO Employee PPO ESI Summary 2023
County of SLO Employee EPO ESI Summary 2023
County of SLO Early Retirees EPO ESI Summary 2023
County of SLO Early Retirees PPO ESI Summary 2023
Express-Scripts-Mail-Order-FAQs
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