![]() ![]() Administration of the medication(s) is usually given daily for 7-10 days early in the cycle. This medication is limited to a lifetime maximum of three (3) cycles of therapy. Injectable medication used to treat infertility is only available to PICA members whose health plan covers the treatment that require this medication. The fertility medication benefit program is available exclusively from Freedom Fertility Pharmacy. Once you have registered you can order refills through the web and verify your copay. Log onto Express Scripts’ website at and register as a member. Simply call 80 and follow the instructions that are given to you over the phone. The Interactive Voice Response (IVR) System enables you to renew prescriptions over the telephone at any time of the day or night. To Refill Medication by ESI Home Delivery You may also call Express Scripts' Customer Service at 80. Medications a member may take for an extended period of time such as those to treat nausea while undergoing cancer treatment would be considered non-specialty maintenance medications. Please note that if your physician changes the strength of your maintenance medication or prescribes a different maintenance medication, you may go to a retail pharmacy for up to two 30 day fills and then you must transfer to ESI Home Delivery Pharmacy. A maintenance drug is a medication that you will be utilizing on a regular basis over an extended period of time. Non-specialty maintenance medications must be sent to ESI Home Delivery Pharmacy. Up to a 30 day supply of specialty medication is available through Accredo Specialty Pharmacy. To find out if your medication is Preferred or Non-preferred, you may call Express Scripts Customer Service at (800) 467-2006 or visit Mail Order This deductible is independent of any other deductible and must be satisfied before copayments are applied. ![]() There is an annual deductible of $100 per person. If the brand is dispensed, the member must pay the difference in cost between the generic and brand drug plus the applicable brand copay. ![]() Specialty Medications (Up to a 30-day supply at Accredo Specialty Pharmacy or Freedom Fertility Pharmacy):įor brand medications that have FDA approved generic equivalents, PICA will pay for the generic medication only. $90 Non-Preferred Brand (Non-Formulary).$45 Non-Preferred Brand (Non-Formulary)Įxpress Scripts (ESI) Home Delivery Pharmacy (Up to a 90-day supply at ESI Home Delivery for non-specialty medications):.Retail (Up to a 30-day supply at a retail pharmacy): ![]()
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