About Your Pharmacy
How your pharmacy coverage works:
| Each time you fill or refill a covered prescription, you will pay a copayment. The copayment amount varies according to the type of pharmacy coverage you have and the type of prescription you fill. Rx copayment amount(s) are listed on your member ID card. |
| If your card lists three copayment amounts, you will pay the lowest amount for generic drugs, the middle amount for brand-name drugs listed on Empire's preferred drug list/formulary and the highest amount for brand-name drugs not listed on the drug list. |
| If your card lists two copayment amounts, you will pay the lower amount for generic drugs and the higher amount for brand-name drugs listed on Empire's preferred drug list/formulary. |
| If your plan covers drugs not listed on the drug list, you will pay the higher amount for those drugs as well. Check your benefit materials to see whether your plan covers brand-name drugs not listed on the drug list. |
| If you are denied benefits for a prescription drug, you may appeal our decision by writing to us at: |
Pharmacy Management Appeals Department
PO Box 5099
Middletown, NY 10940
Or you may call the Member Services number on the back of your ID card.
Your network includes more than 56,000 pharmacies located throughout the United States. That means you have convenient access to prescription medications no matter where you are – at home, on vacation or on a business trip.
| Click here to search for pharmacies that participate in your retail pharmacy network. You can search by zip code, city/state, distance, and by pharmacy name. |
Filling new prescriptions or refills of short-term medications at a participating retail pharmacy is easy. Simply show your ID card at the pharmacy and pay the appropriate copayment.
With The Express Scripts Home Delivery pharmacy (home delivery), Empire’s preferred home delivery pharmacy, convenient prescription delivery is just a phone call away.
With our home delivery pharmacy:
| Depending on your pharmacy benefit plan, you may be able get a 90-day supply of your medication for the same price as two 30-day prescriptions filled at a retail pharmacy. |
| We dispense FDA-approved generic medications unless you or your doctor directs otherwise. Generics usually cost 30-60 percent less than brand-name medications. |
| Care advocates can answer your questions about benefits, savings opportunities and more. |
| You can talk directly to a licensed pharmacist. |
| Your medications are shipped free, right to your door (within 7 calendar days of receipt of a valid order), in unmarked and tamper-resistant packaging (standard shipping). |
We have three separate quality checks to ensure accurate and high quality dispensing:
1. The prescription is entered into our system and checked against your personal information to look for possible allergies, interactions, duplications or other problems.
2. A pharmacist checks the prescription to make sure it’s accurate and checks for medication safety issues.
3. After the prescription goes through our automated dispensing system, another pharmacist verifies that the right medication was dispensed and the prescription was filled accurately.
Transferring prescriptions to The Home Delivery pharmacy
If you have open refills for home delivery prescriptions, they – except for some controlled substances and compounds – will be transferred to the Express Scripts Home Delivery pharmacy. There are certain prescriptions that cannot be transferred, according to state law, and you will need to talk to your doctor about getting a new prescription.
If you are required to get a new prescription, you will be notified by mail. You will need to get a new prescription from your doctor, and then you can place your first order with the Home Delivery pharmacy (see ordering instructions below). Ask your doctor to write two prescriptions: one for a 90-day supply for home delivery and one for a 30-day supply to fill at a local retail pharmacy so you have enough medication until your home delivery prescription is delivered.
Placing your first home delivery order or obtaining a refill is easy
| By phone: Call 1-877-426-1097, Monday through Friday, 8:30 a.m. to 8 p.m., Eastern time.|
| By mail: Simply download our Home Delivery Pharmacy Order Form, and mail the original prescription, the order form and payment information to the address listed on the form.|
To find this form, log in to your health plan website, visit the Pharmacy page, then select “View Your Pharmacy Benefits” to get to Express Scripts’ website. On the Express Scripts site, select the Blank Prescription Order Form from the Printable Forms section.
| Online (for refills): Login to empireblue.com, click on Go to the Pharmacy, then click on Refill a Prescription, located under Quick Links. When you login, you can also review the status of existing orders.|