Express Scripts is one of the country’s largest providers of Medicare prescription drug plans (PDP). On January 1st, 2022, Express Scripts Medicare members were transitioned to Cigna prescription drug plans. They offer three enrollment plans to Medicare beneficiaries.
Unfortunately, Express Scripts is a provider that only offers prescription drug plans, so if you’re looking for a Medicare Supplement or Medicare Advantage plan, you’ll need to look elsewhere.
They offer three Part D prescription drug plans.
The Saver is the coinsurance health plan offering the lowest premium for prescription drug costs. It also has a $0 deductible for most generic drugs in tier 1 & tier 2. The deductible for tier 3, tier 4, and tier 5 is $285. The Saver plan has over 2,900 medications on its formulary.
On the other hand, it has a higher copayment for beneficiaries than other prescription drug coverage plans.
| Pharmacy Type Days’ Supply | Preferred Home Delivery 90 Days | Preferred Retail 30 Days | Standard Retail 30 Days |
|---|---|---|---|
| Tier 1: Preferred Generic Drugs | $0 | $2 | $19 |
| Tier 2: Generic Drugs | $0 | $7 | $20 |
| Tier 3: Preferred Brand Drugs | $105 | $35 | $47 |
| Tier 4: Non-preferred Drugs | 50% | 50% | 50% |
| Tier 5: Specialty Drugs | 28% | 28% | 28% |
The Value plan is known for offering a larger range of drug coverage. It also has a $0 deductible for most generic drugs. There’s a $0 deductible for tier 1, tier 2, and tier 6. The deductible for tier 3, tier 4, and tier 5 is $445. The Value plan has over 3,000 medications on its formulary (drug list).
| Tier 1: Preferred Generic Drugs | $0 | $1 | $10-$19 |
| Tier 2: Generic Drugs | $0 | $3-$9 | $12-$20 |
| Tier 3: Preferred Brand Drugs | $60-$141 | $20-$47 | $26-$47 |
| Tier 4: Non-preferred Drugs | 46%-50% | 46%-50% | 46%-50% |
| Tier 5: Specialty Drugs | 25% | 25% | 25% |
| Tier 6: Select Care Drugs | $0 | $0 | $5-$9 |
The Choice plan gives you the largest range of drug coverage. It also has a $0 deductible for most generic drugs. There’s a $0 deductible for tier 1, tier 2, tier 3, and tier 6. The deductible for tier 4, and tier 5 is $100. The Choice plan has over 3,100 medications on its formulary. Overall, brand-name drugs should also have cheaper cost-sharing amounts with this plan.
| Pharmacy Type Days’ Supply | Preferred Home Delivery 90 Days | Preferred Retail 30 Days | Standard Retail 30 Days |
|---|---|---|---|
| Tier 1: Preferred Generic Drugs | $0 | $2 | $10 |
| Tier 2: Generic Drugs | $4 | $7 | $20 |
| Tier 3: Preferred Brand Drugs | $126 | $42 | $47 |
| Tier 4: Non-preferred Drugs | 46%-50% | 46%-50% | 46%-50% |
| Tier 5: Specialty Drugs | 31% | 31% | 31% |
| Tier 6: Select Care Drugs | $0 | $0 | $11 |
The Saver healthcare plan preferred retail pharmacies include CVS, Walmart, and Kroger. The Value plan preferred retail pharmacies include Walgreens, Walmart, and Kroger. The Choice plan preferred retail pharmacies include Walgreens and Kroger.
Express Scripts owned MedCo, meaning that anything offered by MedCo was actually an Express Scripts plan. But the health insurance company Cigna purchased Express Scripts — and in turn MedCo — so anything with an Express Scripts or MedCo name is owned by Cigna.
MedCo Health and Express Scripts have merged into one company. Because MedCo now operates as a subsidiary of Express Scripts, the company’s new focus is on prescription drugs and prescription drug plans.
Express Scripts will provide you with an ID card to use at pharmacies or wherever you purchase your prescriptions.
The main difference between the Saver, Value, and Choice plans is the range of drug coverage.
Yes, Express Scripts offers a Medicare Part D plan so that beneficiaries can enjoy access to cheaper prescriptions and save money.
To get an Express Scripts Part D drug plan, you will pay a minimum monthly premium of about $17 per month. However, the premium you pay heavily depends on which plan you get and where you live. The plans could be just shy of $100 a month on the highest end.
You can obtain additional information on plan costs with our licensed insurance agents.
What is a Part D coverage gap?
The Part D coverage gap, also called the “donut hole, ” is the initial coverage phase where you have to pay out of pocket for your prescriptions until you’ve met your coverage limit.
If this is causing you financial hardship, you can look for an Extra Help program from Medicare.
Express Scripts Part D plans can be found in all 50 states in America, plus Puerto Rico and Washington, D.C. Express Scripts is strictly Part D benefits for covered drugs, so you can’t get a Medicare Advantage plan through their brand name.
Absolutely! Express Scripts is the largest mail-order provider for prescription drugs in the United States. If you can’t regularly make it to the pharmacy, you can get your medicine refills delivered directly to your home through this prescription drug benefit.
Neither Medicare Part A nor Medicare Part B will pay for prescription drugs. Medicare coverage through supplement plans also doesn’t pay for this benefit. Some Medicare Advantage plans might cover your medicine, but
Express Scripts Part D plans can be overwhelming to compare and understand. That’s why our team of licensed insurance agents is here to help you every step of the way.
Our agents will ensure that the plan covers all your current prescription medications at the lowest price.
So what are you waiting for? Call or complete our online rate form now, and let us help you find the best Express Scripts Part D plan for you.
Written By:
Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
Reviewed By:Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at Medigap.com. He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.
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