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Effective January 1, 2008, the MIT Health Plans will have
expanded pharmacy options for our patients
who need to fill prescriptions during evening or weekend
hours or while traveling. At those times, you
may get up to a 30-day supply of prescribed medications at
any retail pharmacy that is part of the
Express Scripts network. Most major chains participate in
this network. A higher co-pay than at the MIT
Pharmacy will apply to prescriptions filled through the Express
Scripts network. Refills should be
obtained at the MIT Pharmacy where co-pays are lower and
where you can obtain a multi-month
supply of medication if prescribed by your clinician.
The chart below details copays and limitations for the MIT
Pharmacy and participating Express Scripts
pharmacies:
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MIT Pharmacy copay and limitations |
Express Scripts copay and limitations |
| Tier 1 copay |
$8/ up to a 30-day supply |
$15/ up to a 30-day supply |
| Tier 2 copay |
$25/ up to a 30-day supply |
$40/ up to a 30-day supply |
| Tier 3 copay |
$40/ up to a 30-day supply |
$50/ up to a 30-day supply |
| Supply limit |
For many drugs, up to a 90-day supply for double the
30-day copayment |
Limited to a 30-day supply per fill |
| Prescribing physician |
Prescription must be written by an MIT clinician or by a provider to whom member
was referred by an MIT clinician |
No restrictions |
| Mental health prescriptions |
Member must notify MIT Medical, so a referral can be
entered before prescription can be filled |
No restrictions |
| Mail order |
Available through MIT Pharmacy; request can be submitted
through Patient Online. |
Not available |
MIT Flexible Plan members: Under the MIT Flexible Plan, benefits
are available for out-of-network
services, subject to a deductible and coinsurance. MIT Flexible
Plan members who self-refer to outside
providers may get their prescriptions filled only at participating
Express Scripts pharmacies; the copay
amounts listed above will apply. Effective January 1, 2008,
prescription drug claims can no longer be
used to satisfy the out-of-network deductible.
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