Traditional Pharmacy Benefits

Medication Adherence Program (MAP) For Retirees taking Diabetes and Cardiovascular Medications

To make it easier for members to stay healthy and take their medications as directed by their provider, the State Health Plan is providing a special benefit to retired members taking medications for cholesterol, blood pressure and blood sugar. Retired members can order a 90-day supply of their diabetes and heart medications from a participating pharmacy for 2½ times the copay. Click here to see the list of participating pharmacies.

Click here to see the list of medications included in the program. If a member is taking one or more of these medications, they should consider receiving them from a participating pharmacy.

  Up to a 30-day supply 31-60 day supply 61-90 day supply Diabetes and Heart Medication 61-90 day supply from participating pharmacies
Tier 1 Generic Medications*
 $12 $24 $36 $30
Tier 2 Preferred Brand, without a Generic available
 $40 $80 $120 $100
Tier 3 Non-preferred Brand, without a Generic available
 $64 $128 $192 $160
Brand name drug, with a Generic available
 Tier 1 copay + the difference between the Plan's cost of the brand name drug and the Plan's cost of the generic drug, not to exceed $100 per 30-day supply. $30 generic copay + difference

*If a generic is included on the Low Cost Generic list it will continue to be $10 for a 90 day supply.

Savings: Members can save money by receiving up to a 90-day supply for just one lower copayment.

Example: The copay for Januvia, a diabetes medication, is $40 (Tier 2) for a 30-day supply. If Januvia is obtained through this program, it would be $100 for a 90-day supply, with an annual savings of $80.

Automatic Refills: Members may schedule automatic refills of important medications. For mail order, members may opt into this program and would receive a phone call prior to their automatic refill and shipment of the medication. Ask about this option at participating retail pharmacies.

Extended payment plan (mail order only): This allows members to pay for a 90-day supply of a medication over time instead of all at once.

To get started with this program, or if you have questions, call Express Scripts Customer Service at at 800-336-5933.
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