Non-Network Prescription Drug Claims No Longer Covered

Effective November 1, 2004, non-network prescription claims will not be reimbursed unless the member lives in an area where there is no network pharmacy. This change means you must use your prescription drug card at an Express Scripts pharmacy when you fill your prescriptions at a retail pharmacy.

The Health & Welfare Plan contracts with Express Scripts, which is a pharmacy benefits manager (PBM) to keep drug costs as low as possible. Most pharmacies in turn contract with many PBMs, including Express Scripts.

If you use a pharmacy that does not contract with Express Scripts or you fail to use your prescription drug card and pay for the cost of the drugs in full, the Plan will not reimburse even a portion of your costs. The claims office will continue to reimburse a portion on non-network claims, but only if you live in a community that has no pharmacy contracting with Express Scripts.