Pre-Medicare Prescription Plan
The OPERS Prescription Drug Plan
OPERS is partnered with Express Scripts and offers our pre-Medicare participants prescription drug plan. New retirees and covered dependents will receive a new enrollee packet which will include your new ID card, a formulary list and other materials.
OPERS advocates for biosimilar drugs because they are one of the major solutions to helping lower prescription drug costs. View our biosimilars infographic to learn more.
Medication Therapy Management
Medication Therapy Management is a service the OPERS plan offers free of charge. Participants who meet Medication Therapy Management program criteria will be sent a letter explaining the program. The program provides participants with a one-on-one telephone discussion about your medications with a registered pharmacist or licensed pharmacy intern to ensure your medications are appropriate, safe and effective.
This program is designed to lower the risk of drug interactions and possible harmful side effects. To learn more about the service, watch this video. If you have any questions about the program, please call Express Scripts at 1-866-727-5873.
Prior Authorization & Step TherapyExpress Scripts also offers Prior Authorization and Step Therapy Programs that assist with drug management. For more information about these programs, call Express Scripts at 1-800-935-6103.
Maximizing your drug therapy
Under the prescription drug program, OPERS recommends taking generic medications when possible. Currently, 90 percent of prescription drugs taken by OPERS pre-Medicare participants are for generic medications. Increasing your use of generic drugs through the High Performance Formulary plan could be a potential cost savings to you, now and into the future. Click here to view the High Performance Formulary list. You may print a copy of the list to discuss with your provider.
Zero-dollar copays for generic medications to treat certain chronic conditions
In an effort to increase patient compliance and improve health outcomes, OPERS offers participants the opportunity to receive generic medications used to treat certain chronic conditions at no cost. Generic medications prescribed to treat asthma/COPD, heart disease, depression and/or diabetes condition are covered with a $0 copayment. Contact Express Scripts at 1-866-727-5873 with any questions.
There are three avenues, or programs, that retirees can use to receive medications:
1. Retail pharmacy program
Participants can receive up to a 30-day supply of medication, plus refills, as prescribed by their physician. In order to use the retail pharmacy network, they must present their prescription drug ID card and prescription(s) to the pharmacist.
2. Preferred Retail Pharmacy program
Participants are required to use a preferred network of retail pharmacies in order to pay the lowest copay and co-insurance amounts. To find out if a pharmacy is preferred, call the number on the back of your Express Scripts ID card.
3. Home Delivery program
Participants can receive up to a 90-day supply of medication, plus refills, as prescribed by their physician. To use the Home Delivery pharmacy, participants can place an order using the Express Scripts website, by mailing the prescription(s) and the correct copay to Express Scripts, or by calling 1-866-727-5873. TTY users should call 1-800-716-3231.