ARE YOU AN APWU BARGAINING UNIT EMPLOYEE?

Your High Option pharmacy program

The High Option has contracted with 70,432 retail pharmacies throughout the country. These pharmacies belong to the Express Scripts® Health Prescription Solutions network, and the pharmacies discount their charges and bill the Health Plan automatically for you.

The High Option Plan also offers a convenient mail order program for our members with long-term prescription needs. Both programs offer no deductible and low copayments.

Diabetes medications available through mail-order

  • $0 copay for generic oral medication, formulary blood glucose test strips and lancets (used to reduce blood sugar)
  • $25 copay for a 30-day supply of certain insulin and non-insulin drugs to treat diabetes
  • $75 copay for a 90-day supply of certain insulin
  • Standard dispensing limitations apply as outlined in the APWU Health Plan Federal Brochure on page 66
In-network you pay Out-of-network you pay
Retail prescription drugs - non-specialty
(30-day supply)		 $10 for Tier 1 drugs,
25% for Tier 2 drugs, maximum $200 per Rx,
45% for Tier 3 drugs, maximum $300 per Rx, (no deductible)		 50% ($10 minimum coinsurance),

(no deductible)
Mail order prescription drugs - non-specialty
(90-day supply)		 $20 for Tier 1 drugs,
25% for Tier 2 drugs, maximum $300 per Rx,
45% for Tier 3 drugs, maximum of $500 per Rx,
(no deductible)		 N/A
Retail prescription drugs - specialty 25% for Tier 1 drugs, maximum of $300 per Rx,
25% for Tier 2 drugs, maximum $600 per Rx,
45% for Tier 3 drugs, maximum $1,000 per Rx,
(no deductible)		 50% ($10 minimum coinsurance),

(no deductible)
Mail order prescription drugs - specialty 25% for Tier 1 drugs, maximum $150 per Rx,
25% for Tier 2 drugs, maximum $300 per Rx,
45% for Tier 3 drugs, maximum $500 per Rx, (no deductible)		 N/A

With both the mail order and the retail drug programs, there is no paperwork for the member to file. The pharmacy does the work for you.


Learn more about your High Option pharmacy program benefits

Create an account on express-scripts.com or download the Express Scripts mobile app for free from your mobile device’s app store. Registering is safe and simple, and your information is secure and confidential. Please have your member ID number or SSN available.

Once you create an account, you can:

  • Check your order status
  • Refill and renew prescriptions
  • Find your nearest preferred pharmacy
  • View and print member ID cards
  • Enroll eligible prescriptions in automatic refill
  • Set reminders to take your medication
  • Enroll in home delivery

The Express Scripts mobile app is available for iPhone®, iPad®, and Android™ mobile devices.

Whether you use your express-scripts.com account or the Express Scripts mobile app, it's simple and convenient to enroll in home delivery to get your 90-day prescriptions shipped right to your door.

Fill a new prescription

Contact your doctor to request a 90-day prescription that can be e-prescribed directly to Express Scripts home delivery.

Or, print a form by selecting Forms from the menu under Benefits. Print the home delivery form and follow the mailing instructions.

Or, call Express Scripts at 1-800-841-2734 or 1-800-759-1089 (TTY), and we’ll contact your doctor for you.

Please allow 10 to 14 days for your first prescription order to be shipped.

Transfer a retail prescription to home delivery

Select Add to Cart for eligible prescriptions and check out. We’ll contact your provider on your behalf and take care of the rest. Check Order Status to track your order.

Refill and renew prescriptions

Select Add to Cart for eligible prescriptions and check out. We’ll contact your provider on your behalf, if renewals are included, and take care of the rest.

Express Scripts Patient Assurance® Program Participating Drugs on the National Preferred Formulary

PLEASE NOTE: This list is subject to change. Not all of the drugs listed are covered by all prescription plans; check your benefit materials for the specific drugs covered for your prescription plan. This list is effective beginning January 1, 2022.

FARXIGA®
GLYXAMBI®
FLEXTOUCH®
HUMALOG®
HUMALOG® KWIKPEN
HUMALOG® MIX
HUMULIN®
HUMULIN® KWIKPEN
HUMULIN® N
HUMULIN® N KWIKPEN
HUMULIN® R
HUMULIN® R KWIKPEN
JARDIANCE®
LEVEMIR®
LEVEMIR®
LYUMJEV™
LYUMJEV™ KWIKPEN
OZEMPIC®
RYBELSUS®
SEMGLEE®
SYNJARDY®
SYNJARDY®XR
TRIJARDY®XR
TRULICITY®
XIGDUO®XR

All trademarks are the property of their respective owners.

Your prescription plan covers contraceptives at no cost to you

Under the Affordable Care Act, your plan covers contraceptive medications and medical devices approved by the U.S. Food and Drug Administration. There are many contraceptive options available to you that can help prevent pregnancy, including:1

  • Medication taken by mouth (“the pill”)
  • Diaphragm
  • Emergency contraceptives
  • Shot/injection
  • Over-the-counter methods
  • Skin patch
  • Implantable rod
  • Vaginal ring
  • Intrauterine systems (“IUD”)
  • Cervical cap

Consult with your health care provider to ensure you are using the contraception method most appropriate for you, your body and your future.

1 The success rate of contraceptive methods varies, depending on the specific medication or device utilized

Get your vaccinations today at no cost to you

To help you stay healthy, you can receive vaccinations covered by your prescription plan at a participating retail pharmacy. Certain age restrictions may apply; please refer to your plan details.

Call your local pharmacy to:

  • Ask your pharmacist which vaccines are right for you
  • Find out if your pharmacist can administer the recommended vaccinations
  • Learn which vaccinations are covered by your plan

Don’t forget to present your member ID card to the pharmacist.

The following vaccines are available from pharmacists at participating retail pharmacies:

  • COVID-19
  • Hepatitis
  • Pneumonia
  • Flu (seasonal influenza)
  • Human papillomavirus (HPV)
  • Shingles/zoster
  • Tetanus, diphtheria, pertussis
  • Meningitis
  • Childhood vaccines (MMR, etc.)

Please refer to your plan specifications for additional details on the coverage of vaccines at $0 copay.

Talk with your doctor about getting the help you need to quit tobacco

Under the Affordable Care Act, your prescription plan covers several types of treatments that are approved by the U.S. Food and Drug Administration (FDA).

Nicotine-replacement therapies (NRT)—such as the patch, gum, spray or inhaler—are proven effective at helping people quit tobacco use. The success rate is significantly better when two types of NRTs are used.

Medications recommended and covered with $0 copay:

  • Nicotine patch*
  • Nicotine gum, lozenges*
  • Nicotine nasal spray
  • Nicotine inhaler
  • Bupropion SR 150mg tablets
  • Varenicline tablets
* Over-the-counter medication
Coverage limitations may apply; refer to your plan specifications for details

At Accredo, your specialty pharmacy, taking care of you is our focus. You might be newly diagnosed and beginning with a specialty medication, or you might just be new to Accredo. Either way, our specialty-trained pharmacists, nurses, pharmacy techs, and patient care advocates understand chronic and complex conditions. We’re here to help you navigate this journey.

To manage your medications how you want, when you want, visit accredo.com or download the Accredo mobile app from your mobile device’s app store. You can order available refills, check order status, view medication history, and much more.

Your Accredo team works with your doctor to manage your overall medication therapy and make your path as smooth as possible throughout treatment.