Reminder: Express Scripts transition on Jan. 1

Don’t forget, beginning Jan. 1, 2024, Express Scripts and Express Scripts^TM Medicare (PDP) will become the new third-party administrators for the HealthSelect^SM Prescription Drug Program (PDP) and HealthSelect^SM Medicare Rx, respectively. The current administrators, Optum Rx (non-Medicare) and UnitedHealthcare^® (Medicare) will continue to manage the plans through Dec. 31, 2023.

ID cards have been sent

Express Scripts has sent welcome packets to all current plan participants. The packets contain two ID cards per household to use beginning Jan. 1, a mail order form and a plan guide with details of your prescription drug coverage along with the contact information for Express Scripts.

Will your coverage change?

The formulary will change on Jan. 1, meaning that some drugs might change tiers and participants might pay more or less for the same drug starting Jan. 1. In addition, Express Scripts could require prior authorization or step therapy for drugs that don’t need them under the current administrators. ERS is taking measures that will give participants time to work with their doctors to manage any changes.

HealthSelect Medicare Rx (Medicare-enrolled participants)

If you are currently (before Jan. 1) taking a medication that:

• is not in Express Scripts’ formulary, you will have the option to get a one-month transition refill. When that one-month refill runs out, you will have to get an alternative medication or pay more for the current drug
• does not require prior authorization or step therapy now, but will starting Jan. 1, you will have the option to get a one-month transition refill. When the one-month refill runs out, the drug will require prior authorization or step therapy.
• requires prior authorization or step therapy now (under UnitedHealthcare) and is in Express Scripts’ formulary:
  • If the drug will continue to require prior authorization or step therapy under Express Scripts, current coverage of the drug will be honored until the prior authorization or step therapy expires. After that, the drug will have to go through a new prior authorization or step therapy, and you might pay a different price depending on what formulary tier the drug is in.
  • If the drug will be in Express Scripts’ formulary and won’t require prior authorization or step therapy, current coverage of the drug will be honored until the prior authorization or step therapy expires. After that, you can fill a prescription for the drug without prior authorization or step therapy, but you might pay a different price depending on what formulary tier the drug is in.

HealthSelect Prescription Drug Program (non-Medicare participants)

If you are currently (before Jan. 1) taking a medication that:

• is not in Express Scripts’ formulary, you will continue to have access to that drug under the current coverage until March 31, 2024. Beginning April 1, you will have to get an alternative medication or pay more for the current drug.
• does not require prior authorization or step therapy now, but would under Express Scripts, ERS will waive the prior authorization/step therapy requirement for that medication, even if you have to renew the prescription. (Note: If you aren’t taking the medication before Jan. 1, you will have to get prior authorization or go through step therapy to start using it on or after Jan. 1.)
• requires prior authorization or step therapy now (under OptumRx) and is in Express Scripts’ formulary:
  • If the drug will continue to require prior authorization or step therapy under Express Scripts, current coverage of the drug will be honored until the prior authorization or step therapy expires. After that, the drug will have to go through a new prior authorization or step therapy, and you might pay a different price depending on what formulary tier the drug is in.
  • If the drug will be in Express Scripts’ formulary and won’t require prior authorization or step therapy, current coverage of the drug will be honored until the prior authorization or step therapy expires. After that, you can fill a prescription for the drug without prior authorization or step therapy, but you might pay a different price depending on what formulary tier the drug is in.

Find a pharmacy

Use the “Find a pharmacy” tool and the “Price a medication” tool online to see your out-of-pocket costs. If you have questions, see the table below for whom to contact for your plan.

Register your account online

Register for an account, depending on your plan, at HealthSelectRx.com or HSMedicareRx.com beginning Jan. 1.

Express Scripts Q&A Webinars

If you are not enrolled in Medicare, you can join a HealthSelect PDP Q&A session with Express Scripts to learn more about your coverage:

• Tue., Dec. 12 at 10 a.m. CT
• Wed., Dec. 13 at 2 p.m. CT
• Tue., Dec. 19 at noon CT

Express Scripts was available to answer Medicare participants’ questions during Fall Enrollment.