Prescription drug
When you elect medical coverage through Schneider Electric, you also get prescription drug benefits through Express Scripts.
If you live in Puerto Rico, your medical and prescription drug coverage is administered by Triple S (Blue Cross and Blue Shield of Puerto Rico). You will receive a separate insert regarding coverage details and cost.
Is your pharmacy in the network?
To find an in-network pharmacy near you, sign in at Express-Scripts.com > Locate a Pharmacy. If you are a first-time visitor to Express-Scripts.com, first register, using your member ID number.
Brand-name drug cost when generic is available.
If you or your doctor requests a brand-name medication and indicates “dispense as written” when a generic equivalent is available, you will pay the generic copay plus the cost difference between the brand and the generic. You or your doctor may request a coverage review to waive the cost difference between the brand and generic medication by contacting Express Scripts.
Filling your long-term/maintenance medications.
You can fill your first two prescriptions for a maintenance medication at a retail pharmacy for up to a 30-day supply. All additional long-term prescriptions (90-day supply) for maintenance medications must be filled through either a Walgreens or CVS pharmacy or the Express Scripts home delivery pharmacy to be covered by the plan. Learn more at Express-Scripts.com.
Certain specialty drugs at no cost under the Core PPO.
Under the Core PPO, certain specialty drugs may be at no cost through SaveonSP, who helps coordinate manufacturer-sponsored assistance. Learn more at Express-Scripts.com.
Comparing prescription drug benefits
Plan provision | Core CDHP + HSA | Buy-up CDHP + HSA | Core PPO | ||||
You pay in-network | You pay out-of-network | You pay in-network | You pay out-of-network | You pay in-network | You pay out-of-network | ||
Deductible (combined with medical) | |||||||
Single | $3,000 | $6,000 | $1,500 | $3,000 | NA | ||
Family | $6,000 | $12,000 | $3,000 | $6,000 | NA | ||
Out-of-pocket maximum1 | |||||||
Single | $5,600 | $11,200 | $4,450 | $8,900 | $3,700 | $7,400 | |
Family | $11,200 | $22,400 | $7,150 | $17,800 | $7,400 | $14,800 | |
Prescription drugs2 | |||||||
Retail (30 day supply) | |||||||
Generic | 20% (after you meet the annual deductible) | 40% (after you meet the annual deductible) | 20% (after you meet the annual deductible) | 40% (after you meet the annual deductible) | $10 copayment | ||
Preferred brand | 20% coinsurance ($30 min / $60 max) | ||||||
Brand | 40% coinsurance ($60 min / $120 max) | ||||||
Preventive3 | $10 copayment for generic drugs (no deductible) 20% for preferred brand and brand name drugs (no deductible) | NA | |||||
Mail order, CVS or Walgreens (90 day supply)4 | |||||||
Generic | 20% (after you meet the annual deductible) | No coverage | 20% (after you meet the annual deductible) | No coverage | $25 copayment | ||
Preferred brand | 20% coinsurance ($75 min / $150 max) | ||||||
Brand | 40% coinsurance ($150 min / $300 max) | ||||||
Preventive3 | $25 copayment for generic drugs (no deductible) 20% for preferred brand and brand name drugs drugs (no deductible) | NA |
- The out-of-pocket maximum includes expenses paid toward your deductible, as well as medical and prescription drug copayments and coinsurance amounts.
- For specialty drugs under the Core PPO: Certain specialty drugs may be at no cost through SaveonSP, who helps coordinate manufacturer-sponsored assistance.
- Go to express-scripts.com/schneiderelectric to check how medications are classified. Any drugs considered preventive for ACA purposes do not have a copay.
- After two fills, long-term prescriptions for maintenance medications must be filled through a Walgreens or CVS pharmacy or the Mail Service Program to be covered by the plan.