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Who are the in-network providers for my medical insurance plan with UnitedHealthcare?

The list of in-network providers for each medical plan is available online from UnitedHealthcare's website. If you already have a myUHC.com account, log in to view your list of network providers and facilities. If you do not yet have an account, you may visit the comparison website created by UnitedHealthcare for university employees.

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What services and tools does UnitedHealthcare provide?

UnitedHealthcare offers many tools to help make your medical insurance coverage work for you. The myUHC Cost Estimator can help you estimate your out-of-pocket health care costs prior to seeing a doctor. Additionally, the tool allows you to compare health cost estimates at different providers so you can be sure you’re making an informed decision about what is best for you.

The Health4Me app is another resource for accessing a wealth of healthcare information in seconds. The app lets you check your account balances and benefit amounts, stores your health plan ID card, collects and tracks your current Personal Health records, and helps you view, sort, and pay claims. Additionally, you can use the app much like you use the myUHC Cost Estimator when you compare costs of common procedures. You can even connect with healthcare professionals 24/7 as well as find in-network providers and hospitals nearby in case of emergency.

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What Is Step Therapy through Express Scripts?

Step therapy is a program for people who take prescription drugs regularly to treat a medical condition, such as arthritis, asthma or high blood pressure. It allows you and your family to receive the affordable treatment you need and helps your organization continue with prescription-drug coverage.

In step therapy, drugs are grouped in categories, based on treatment and cost:

Front-line drugs — the first step — are generic and sometimes lower-cost brand drugs proven to be safe, effective and affordable. In most cases, you should try these drugs first because they usually provide the same health benefit as a more expensive drug, at a lower cost.
Back-up drugs — Step 2 and step 3 drugs — are brand-name drugs that generally are necessary for only a small number of patients. Back-up drugs are the most expensive option.

If you have more questions, you can go to StepTherapyFacts.com to watch informative videos or call the Express Scripts Pharmacy at the number on your ID card. (This FAQ answer provided by ExpressScripts.)

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How do I maximize my Express Scripts prescription drug benefit?

In order to make the most of your prescription drug benefit through Express Scripts, it’s a good idea to use FDA-approved generic drugs whenever possible. If you are taking a brand-name drug that is not on the plan’s preferred drug list (called a “formulary”), ask your doctor if a preferred- brand drug or a generic would be right for you.

Similarly, fill prescriptions through a retail pharmacy in the Express Scripts network, or via home delivery from the Express Scripts PharmacySM. (Filling a greater than a 32 day supply of maintenance prescriptions at a University pharmacy is the same copay as home delivery.) Of course, many local pharmacies offer other low-cost generic programs, so it’s always a good idea to compare prices at all pharmacies to ensure the best price.

(This FAQ answer provided by Express Scripts.)

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Who decides what drugs are covered in the ExpressScripts Step Therapy program?

Step therapy is developed under the guidance and direction of independent, licensed doctors, pharmacists and other medical experts. Together with Express Scripts — the company chosen to manage your pharmacy benefit plan — they review the most current research on thousands of drugs tested and approved by the FDA for safety and effectiveness. Then they recommend appropriate prescription drugs for the step therapy program, and your organization’s pharmacy benefit plan chooses the drugs that will be covered. (This FAQ answer provided by ExpressScripts.)

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I’m in the step therapy program. Why couldn’t I fill my prescription at the pharmacy?

The first time you submit a prescription that isn’t for a front-line drug, your pharmacist should inform you that with step therapy you need to first try a front-line drug if you’d rather not pay full price for your prescription drug.

To receive a front-line drug:

  • Ask your pharmacist to call your doctor and request a new prescription.

OR

  • Contact your doctor to get a new prescription.

Only your doctor can change your current prescription to a first-step drug covered by your program.

 

If you have more questions, you can log in and go to www.StepTherapyFacts.com to watch informative videos or call the Express Scripts Pharmacy at the number on your ID card. (This FAQ answer provided by ExpressScripts.)

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What’s the difference between generic and brand-name prescription drugs?

FDA-approved generic drugs must meet the same U.S. Food and Drug Administration (FDA) standards of quality and purity as brand-name drugs. FDA-approved generic versions have the same active ingredients as their brand-name counterparts are equal in strength and dosage. Sometimes drug manufacturers use different inactive ingredients in generic versions, which may affect its shape, color, size or taste.

(This FAQ answer provided by Express Scripts.)

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How are large discount stores able to offer generic prescription drugs for $4.00?

Nationwide discount stores often offer “in the door” pricing which allows them to offer lower costs on certain drugs to promote shopping at their location. You have the option of considering purchasing your prescriptions at different locations. Finding out what the price is at multiple locations is a great way to check that you are getting the best price, but don’t forget to factor in the cost of driving to multiple locations versus getting your prescriptions all one place or through mail order.

(This FAQ answer provided by Express Scripts.)

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I’m in the ExpressScripts Step Therapy program; what if I need a prescription filled immediately?

If you’ve just started taking a prescription drug regularly or if you’re a new plan member, you may be informed at your pharmacy that your drug isn’t covered. If this should happen and you need your medication right away, you can talk with your pharmacist about filling a small supply of your prescription right away. (You may have to pay full price for this quantity of the drug.) Then, to ensure your medication will be covered by your plan, ask your doctor to write you a new prescription for a front-line drug. Remember: only your doctor can change your prescription to a front-line drug.

If you have more questions, you can go to StepTherapyFacts.com to watch informative videos or call the Express Scripts Pharmacy at the number on your ID card. (This FAQ answer provided by ExpressScripts.)

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When pricing my prescriptions, why should I consider generics or preferred brand-name drugs?

You may save money since generics or preferred brand-name drugs usually cost less than non-preferred brand-name drugs. There are generic versions to many brand-name drugs and many new generics become available on a regular basis. Check with your doctor if a lower-cost generic or preferred brand-name drug would be the right option for you.

(This FAQ answer provided by Express Scripts.)

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How do I start using the Express Scripts Pharmacy for home delivery?

You can choose one of these easy methods:

  • Call Express Scripts at 877-603-1032, and let them do all the work. For most medications, Express Scripts will be able to contact your doctor and arrange for your first mail-order supply.
  • Ask your doctor for a new prescription for up to a 90-day supply, plus refills for up to one year (if appropriate). Then, have your doctor fax the prescription to the Express Scripts Pharmacy. (Only your doctor can fax your prescriptions.)

For refills remaining on covered medications you take regularly and fill at a retail pharmacy, log into Express-Scripts.com, scroll down the Order Center page to "Transfer your retail prescriptions," and select the medications you'd like to transfer. Express Scripts will do the rest. (If you’re a first-time visitor to the Express Scripts website, please take a moment to register using your member ID number and a recent prescription number.)

[This FAQ provided and written by Express Scripts.]

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For the ExpressScripts Step Therapy program, what do I do if I can’t use the front-line drug?

With step therapy, more expensive brand-name drugs are usually covered as a back-up in the program if:

You’ve already tried the generic drugs covered in your step therapy program
You can’t take a generic drug (for example, because of an allergy)
Your doctor decides, for medical reasons, that you need a brand-name drug

If one of these situations applies to you, your doctor can request an override or a “prior authorization” for you, allowing you to take a back-up prescription drug. Once the override is approved, you’ll pay the appropriate copayment for this drug. If the override isn’t approved, you will either have to pay full price for the back-up drug or take an alternative.

If you have more questions, you can go to StepTherapyFacts.com to watch informative videos or call the Express Scripts Pharmacy at the number on your ID card. (This FAQ answer provided by ExpressScripts.)

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How do I find out which prescription drugs are considered “preferred” drugs?

To see if a medication is one of the thousands covered on the preferred drug list for the currently plan year, visit the Express Scripts official website, www.express-scripts.com and select “Price a Medication” from the drop-down menu under “Manage Prescriptions.” If the prescription drug you are looking for is not on the preferred list, talk with your doctor to identify an appropriate alternative that will effectively treat your condition.

(This FAQ answer provided by Express Scripts.)

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How long will it take to receive my home delivery medications from Express Scripts?

Usually, you’ll receive your medication within eight days after we receive a new prescription and about five days after we receive your refill request.

When ordering a covered medication for the first time through Express Scripts home delivery, please ask your doctor to write two prescriptions:

  • One for up to a 90-day supply to have filled through home delivery.
  • One for a 30-day supply to fill at a participating refill pharmacy while your home delivery prescription is processed and shipped.

[This FAQ provided and written by Express Scripts.]

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How can I avoid running out of medication when I use home delivery?

For your convenience, Express Scripts offers the Worry-Free Fills® program, a service that provides you with automatic refills on eligible medications you take regularly. Your medication will be shipped on the next refill date, prior to when the supply from your current fill would run out. To see whether your medications are eligible and to enroll in the program, call Express Scripts at 877-603-1032 or log into the website at Express-Scripts.com.

[This FAQ provided and written by Express Scripts.]

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How can I check the status of my prescription order?

Orders are usually processed by Express Scripts and mailed within 48 hours of receipt. Please allow eight days from the day you mail in your prescription. You can check on the status of your order by logging into Express-Scripts.com and selecting “Check Order Status” from the drop-down menu under “Manage Prescriptions.” Or you can call Member Services and use the automated system. If you’re a first-time visitor, take a moment to register. Have your member ID number handy.

[This FAQ provided and written by Express Scripts.]

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How can I find out how much my medication costs with Express Scripts home delivery?

Log in at Express-Scripts.com, select “Price a medication” from the menu on the left side of the screen, and follow the instructions to enter your medication name. You can also call Express Scripts at 877-603-1032.

[This FAQ provided and written by Express Scripts.]

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How do I pay for my Express Scripts home delivery prescriptions?

You can pay by check, e-check, money order, or credit card. If you prefer to use a credit card, you have the option of joining Express Scripts’ automatic payment program by calling 800-948-8779 or by enrolling online. If you currently use a credit card for your home delivery prescriptions, you’ll need to contact Express Scripts with your credit card information, as this information can’t be transferred.

E-check is another term for electronic fund transfer. When you pay for home delivery prescriptions with e-check, your copayments are conveniently deducted from your checking account. Plus, there’s a 10-day grace period between the time your order is sent and when the amount is deducted from the assigned checking account. (The amount that is being deducted will be included in the prescription information that accompanies your order.)

[This FAQ provided and written by Express Scripts.]

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Is there an additional charge for shipping and handling with Express Scripts home delivery?

No. Medications are shipped via standard service at no cost to you. Express shipping is also available for an additional fee.

[This FAQ provided and written by Express Scripts.]

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If I send more than one prescription for home delivery, will it be shipped in more than one package?

It is possible, since not all of the Express Scripts home delivery pharmacies dispense the same medications.

[This FAQ provided and written by Express Scripts.]

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For home delivery, how do I know if my medication is covered or if there is a generic equivalent?

To find coverage and pricing details online, and to find out if your medication has a generic equivalent, sign in at Express-Scripts.com and select “Price a Medication” from the drop-down menu under “Manage Prescriptions.” After you look up a medication’s name, click “View coverage notes.” Or you can contact Express Scripts Member Services.

[This FAQ provided and written by Express Scripts.]

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Will Express Scripts home delivery automatically substitute generic drugs when ordering brand-name?

Yes. Express Scripts mail-order pharmacies will automatically fill prescriptions with generic equivalents (if available), unless you specifically request the brand-name drug or your doctor has indicated DAW (dispense as written) on the prescription.

Please remember that if you choose to purchase a brand-name drug that has a generic equivalent, you will be charged your generic/brand co-payment, plus the cost difference between the brand and the generic.

[This FAQ provided and written by Express Scripts.]

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Who has access to my prescription information when using Express Scripts home delivery?

Express Scripts has a strong commitment to your privacy. Express Scripts has established effective administrative and technical safeguards to protect the confidentiality of your prescriptions and other information, and to secure this information from unauthorized or improper access, disclosure, or use. In addition, Express Scripts does not sell individually identifiable information nor lists of members and their covered dependents to outside companies for solicitation or marketing purposes.

[This FAQ provided and written by Express Scripts.]

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What are generic drugs?

Generic alternatives have the same chemical makeup and same effect in the body as their original brand-name counterparts. Though generics may have a different name, color, and/or shape, generics have undergone rigorous clinical testing and been approved by the U.S. Food & Drug Administration (FDA) as safe and effective.
Unlike manufacturers of brand-name drugs, the companies that make generic drugs don’t need to spend as much money on research and advertising. As a result, generic drugs cost less than the original brand-name drug, and the savings get passed on to you.

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What kinds of things can I do by registering on the Express Scripts website?

By registering at www.express-scripts.com (you will be asked for your Member ID number and email address), you can:

  • Get information about your plan and participating retail pharmacies near you.
  • See how much certain medications will cost and find lower-cost options.
  • Refill and renew home delivery prescriptions.
  • Check order status and receive timely medication alerts.
  • Ask questions of a pharmacist online.

(This FAQ answer provided by Express Scripts.)

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How can the Express Scripts Mobile App help me?

The Express Scrips Mobile App can be downloaded from your device’s application store for free. Register or log-in with the same information as www.express-scripts.com. The app has a virtual member ID card you can present at the pharmacy, and using the app can help you view your current medications, and set reminders to take medicines or refill prescriptions.

(This FAQ answer provided by Express Scripts.)

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Why was I told I need to use front-line drugs for Express Scripts Step Therapy home delivery?

Step therapy applies to prescriptions you receive at your local pharmacy, as well as those you order through home delivery, so the same basic process applies. Your doctor may write a prescription for a front-line drug covered by your plan, or your doctor can request an override.

If you have more questions, you can go to StepTherapyFacts.com to watch informative videos, or call the Express Scripts Pharmacy at the number on your ID card. (This FAQ answer provided by ExpressScripts.)

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