The prescription drug vendor for all employees participating in the Village's medical plans is Express Scripts.

Below are definitions for the various prescription drug co-payment tiers:

  • Generic (Generic) - The cost a plan member pays if the prescription is filled with a generic drug.
  • Formulary (Single-Source Brand) - The cost a plan member pays if the prescription is filled with a brand-name drug.
  • Non-Formulary (Multi-Source Brand) - The cost that a plan member pays if the prescription is filled with multi-source (non-formulary) drug when a generic or single-source (formulary) substitute drug is available. In most cases when a drug becomes Multi-Source, it will be moved to the Non-Formulary tier (highest co-payment). Multi-source (non-formulary) co-payments are intended to encourage plan members to use the generic versions of a drug when one is available or to use a single-source (formulary) drug instead of a multi-source (non-formulary) drug.

Express Scripts updates its formulary list on a quarterly basis and the list is created by an independent panel. You can visit Express Scripts online at www.express-scripts.com to see if a specific drug is on the formulary listing.

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Smart 90 Program

How Smart 90 Works (Long-term/maintenance medications) 

NOTE: All long-term (maintenance) medications must be filled at a three-month (90 day) supply through Express Scripts mail order, Walgreens or CVS (Effective 7/1/2019). 90 day supplies ordered through Express Scripts,  Walgreens or CVS (Effective 7/1/2019) are the equivalent to the cost of two (2) times the typical thirty (30) day supply. 

Mail order specialty drugs: Requires pre-authorization prior to dispensing.
All Benefit Eligible Employees: $350 flat copay

Advanced Utilization Management - Depending on your prescription, you may be prompted to either: consult with your doctor, discuss with your pharmacist or contact Express Scripts.

  • Prior Authorization - Confirming with your physician that the drugs you are taking are the safest, most effective medicines available based on approved FDA and published clinical trials and guidelines.
  • Step Therapy - Having you try generics or lower cost preferred drugs that are similar to your current prescription and are FDA-approved medicines.
  • Drug Quantity - Managing dosage and quantities of your prescriptions more effectively.

Important Information

  • Member Services phone number (800)711-0917
  • Express Scripts Web Site (register online to print a temporary ID card, refill mail order prescriptions, etc.)
    • To look up formulary drugs, log into your account on the Express Scripts website and click on "Learn about formularies", under Planning & reference on the left hand side of the screen. 
  • Mail Order Form
    You may mail the order form to:
    Medco Health Solutions of Dallas
    P.O. Box 650322
    Dallas, TX 75265-0322
  • Express Scripts Prescription Drug Reimbursement Form 

(Filing prescription claims forms is typically unnecessary as pharmacists are to bill Express Scripts directly.)

Submit reimbursement claim forms to:

Express Scripts
PO Box 14711
Lexington, KY 40512

Important: First time prescriptions should be completed by the subscriber/patient through completing the Mail Order Form. It is important to include payment information on the form. Express Scripts will not dispense a prescription unless the payment (i.e. e-check (complete above form), personal check, credit card or send bill (Express Scripts will ONLY send bill if the order total is $100.00 or less) section is completed or they have payment information on file for the subscriber/patient. If an order is received without payment information and exceeds $100.00 this will delay processing of the order until payment information is received.

Please continue to refill your prescriptions as you normally would by using your current prescription drug ID card, refill order forms, our website, or the toll-free member services telephone number on your ID card.