Prescription Drug Plan

Affordable prescription drug coverage is included in each of the University’s medical plans. You can fill your prescriptions either at a retail pharmacy or through the mail. 

Administered by Express Scripts (merged with Medco in 2012) , you pay for prescriptions with a copayment that is determined by whether you purchase generic, brand name or multi-source drugs, and whether you use a retail pharmacy or the lower cost mail-order program.
 
 
Retail Pharmacy (30-Day Supply)
Mail Order (90-Day Supply)
Generic
$5 copayment
$10 copayment
Single-Source Brand
$25 copayment
$50 copayment
Multi-Source
Member pays the difference
Member pays the difference
 
Infertility Coverage (oral and injectable medication): same as above up to a $20,000 lifetime maximum.
 
Generic: A drug whose formula is equivalent to that of a brand name drug. 
Single-Source Brand: An original formula drug with no generic equivalent. 
Multi-Source: A drug that is available in generic and brand. When your physician chooses to prescribe a brand name drug when there is a generic equivalent, your copayment is based on “member pays the difference”.  You will pay the generic copayment, plus the difference between the Plan’s cost of the generic drug and the Plan’s cost of the brand drug.
 
Speciality Medications - some speciality medications are not covered at a retail pharmacy and may be purchased only through Express Scripts Speciality Pharmacy, Accredo.
 

You will receive a separate ID card for the prescription drug program administered through Express Scripts. 

If you need to purchase a prescription at a participating retail pharmacy before you receive your ID card, please provide the pharmacist with the following information: 

Provider:
Express Scripts
Member ID #:
Will be system generated
Phone number:
(800) 711-0917
 
If your name does not appear in the system yet, you should pay for your prescription, submit the receipt along with the Express Scripts claim form to Express Scripts. The claim form can be found here or by calling the Benefits Team at 258-3302. 
 
Princeton University participates in Prior Authorization, Step Therapy, and Quantity Duration Programs for certain prescribed medications. An Express Scripts pharmacist may need to speak with the prescribing physician to ensure that the patient meets the criteria for the prescription prescribed.  In addition, the quantity of some prescription medications may be limited based on FDA regulations ensuring patient safety.  If your physician deems it necessary for your care and treatment, he or she may appeal Express Scripts' decision.

Healthy Savings!

Through Express Scripts by Mail, prescriptions are delivered to your home, and you can get a 90-day supply of maintenance medications for the cost of a 60-day supply purchased at a retail pharmacy.
 
There is a Home Delivery Incentive Program through Express Scripts by Mail for participants who are on maintenance medication.  If you fill your maintenance prescriptions through Express Scripts Home Delivery Service (mail order), you will receive a three month (90-day) supply for the cost of a two month (60-day) supply.  However, if you renew your prescription for maintenance medication through a retail pharmacy for more than three months, subsequent refills will cost twice the retail pharmacy co-payment rate.
 
 
You can count on support from knowledgeable and responsive HR staff when you have a benefits question or problem. Just call or e-mail us. We’re here to help!