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
  1. The out-of-pocket maximum includes expenses paid toward your deductible, as well as medical and prescription drug copayments and coinsurance amounts.
  2. For specialty drugs under the Core PPO: Certain specialty drugs may be at no cost through SaveonSP, who helps coordinate manufacturer-sponsored assistance.
  3. Go to express-scripts.com/schneiderelectric to check how medications are classified. Any drugs considered preventive for ACA purposes do not have a copay.
  4. 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.

 

You’re in charge with the CDHP + HSA options.

Why Scott Simms picked the Core CDHP + HSA.

Tips for better health and savings

Get rewarded for your healthy habits.

Available to you and your spouse (if they’re covered on a Schneider Electric medical plan), Virgin Pulse can help you prioritize well-being goals and activities each day.

  • Healthy habits: Select healthy habits you want to focus on and track your progress.
  • Challenges: Work toward your goals in a fun, competitive atmosphere by joining corporate challenges. You can even challenge yourself – or your friends – to live a healthier life by creating your own personal challenges.
  • Activity tracking: Tracking activities through Virgin Pulse – like steps, workouts and sleep – helps you visualize your progress and earn rewards! Track easily by syncing on your phone or on your activity tracker, or enter your activities manually.
  • Reach your goals: Get help to stay focused on achieving specific health goals with resources like sleep and nutrition guides as well as personal health coaches.
  • So much more: Get more fuel for your daily well-being goals by exploring everything Virgin Pulse has to offer, including Journeys, virtual fitness and mindfulness sessions and more!

Hear how Kara Greer uses the workout reminders from Virgin Pulse.