Citi Benefits Handbook
Prescription Drugs
Express Scripts (ESI) manages the Citigroup Prescription Drug Program (Program) for participants in the ChoicePlan 500 (CP500), High Deductible Health Plan (HDHP) and Oxford Health Plans Preferred Provider Organization (Oxford PPO). The Citigroup Prescription Drug Program is a component of the Citigroup Health Benefit Plan.
Prescription drug benefits for HMOs are provided through the HMOs and are not included here. Contact your HMO for information about its prescription drug benefits.
Express Scripts covers Food and Drug Administration (FDA)-approved (federal legend) medications that require a prescription from your physician. The Program will also cover certain over-the-counter (OTC) products in compliance with the Affordable Care Act. If you have any questions about whether a medication is covered, call Express Scripts at 1 (800) 227-8338.
Express Scripts offers three ways to purchase prescription drugs:
1. Through a network of retail pharmacies nationwide, where you can obtain prescription drugs for your immediate short-term needs, such as an antibiotic to treat an infection;
2. Through the Express Scripts Home Delivery program, where you may save money by having your maintenance and preventive drugs delivered by mail; and
3. Through the ESI Specialty Pharmacy known as Accredo Health Group (Accredo). You can fill your first two specialty drug prescriptions at a retail pharmacy or at Accredo; for the third and future specialty prescription refills, you must use Accredo.
You will pay a deductible, as shown in "Prescription Drug Benefits at a Glance", for drugs purchased at a retail pharmacy, through mail order, or through Accredo before the Program will pay benefits. You will never pay more than the cost of the drug.