Non-Medicare Pharmacy Benefits
Express Scripts Inc administers the prescription drug benefits on your WSHIP plan. Express Scripts Inc is a leading pharmacy benefit manager with the nation's largest mail order pharmacy operations, including over 1,100 specialist pharmacists trained in specific chronic conditions, and more than 60,000 participating retail pharmacies. If you have questions about your pharmacy benefits, please call Express Scripts Inc Member Services at 1-800-859-8810.
Prescription Drug Plan Information
- Review our prescription drug benefit highlights
- Find participating retail pharmacies near you (and get driving directions)
- Compare prescription drug costs
- View our formulary and look up medications by name
- Use Express Script Inc’s online savings tool to find lower-cost alternatives to your medications
Standard Plan $500 deductible
Standard Plan $1,000 deductible
Standard Plan $1,500 deductible
Preferred Provider Plan $500 deductible
Preferred Provider Plan $1,000 deductible
Preferred Provider Plan $2,500 deductible
Preferred Provider Plan $5,000 deductible
Limited Preferred Provider Plan “A” $1,500 deductible
Learn about Three-Tiered Pharmacy Benefits
View our Preferred Prescriptions Drug List (Formulary)
Your prescription drug benefit includes the Preferred Prescriptions® Formulary, which is a list of commonly prescribed brand-name and generic medications. The medications included in the formulary, which is managed by Express Scripts Inc, are selected because they can safely and effectively treat most medical conditions while helping to contain overall costs. Download Preferred Prescriptions® Member Guide.
NOTE: This guide is a partial list containing many commonly prescribed medications. For the most complete and up-to-date information log on to www.express-scripts.com\wship or contact Express Scripts Inc Member Services at 1-800-859-8810.
To find lower-cost alternatives for your medications, you can use Express Scripts Inc’s My Rx Choices® prescription savings tool at www.express-scripts.com\wship. For your convenience you may print out a list of the alternatives and ask your doctor whether a lower-cost generic or preferred brand is right for you. You may also call 1-800-319-7750 for My Rx Choices® information.
How to use Express Scripts Inc’s website, www.express-scripts.com\wship: If you’re a first-time user of the Express Scripts Inc website, please take a moment to register (click on “Register Now” on the right side of the screen). To register, you will need your WSHIP ID number and a recent prescription number (if you have one). Once you are registered, simply log on to the site by entering your email address and password in the boxes located below “Already Registered?”
Learn about Coverage Reviews
Your prescription drug benefit includes programs that help manage costs while ensuring that you have access to the medications you need. These programs use plan rules based on FDA-approved prescribing and safety information, clinical guidelines, and uses that are considered reasonable, safe, and effective.
With these programs, some medications may not be covered unless you receive approval through a coverage review. There may also be a maximum quantity or dose that’s covered by your plan for certain medications. If you submit a prescription for a medication that has coverage limits, your pharmacist may fill the prescription up to the amount allowed. If the prescription exceeds the amount allowed by your plan, Express Scripts Inc will alert the pharmacist and indicate whether a coverage review is available for an amount above the limit. During a coverage review, Express Scripts Inc asks your doctor for information beyond what is on the prescription in order to determine if the medication or quantity/dose may be covered under your plan.
How to request a coverage review:
Your pharmacist will let you know if your prescription requires a coverage review (also called “prior authorization”). Often times, the pharmacist will call your doctor for you or you may call Express Scripts Inc Member Services for assistance in requesting a coverage review. Your physician requests a coverage review by calling Express Scripts toll-free at 1-800-417-1764. If the review is approved, you will pay your plan’s appropriate copay for the prescription. If it is not approved or your doctor does not request a coverage review, you will be responsible for the full cost of the prescription. Most reviews can be completed within 12-24 hours of your doctor’s request for a coverage review. An appeals process is available for these programs.
For coverage information on the drugs you are currently taking, log on to www.express-scripts.com\wship or contact Express Scripts Inc Member Services at 1-800-859-8810.
Download Pharmacy-Related Forms