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Prior authorization A requirement that your doctor explains why you need a certain medication before your plan decides how and if it will be covered.

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage.

For each of your drugs that is not on our formulary, or if your ability to get your drugs is limited, we will cover a temporary supply of a maximum 30-day supply at retail unless you have a prescription written for fewer days when you go to a network pharmacy within the first 90 days of the calendar year or the first 90 days of your effective date if your coverage begins after the first of the year.

Your prescriber may also request a Coverage Review by using our.

Orders must be placed before 5 PM, Mon — Sat, and Sun before 2 PM excluding holidays for same day pickup.

Louis, MO 63166-6571 Mail a Coverage Determination form to: Express Scripts Attn: Medicare Reviews P.

If your drug has a quantity limit, you can ask us to waive the limit and cover more.

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Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

None of the questions in this application are intended to elicit information regarding any protected characteristics, nor imply any limitation, illegal preferences or discrimination based upon non-job-related information or protected characteristics.

Additional programs and support Other support and wellness programs include a fitness benefit to help you stay in shape as well as coaching programs to address complex conditions, mental health, and diabetes.

Capture and enrich data from any source using our APIs and adapters• Replace a brand-name drug with a generic drug If we make certain changes to our formulary for a drug you are taking, we will either notify you at least 30 days before the change is made or notify you after the change is made and give you a 30-day refill of the drug at a network pharmacy.