Highmark issued letters to individual and small group ACA members in central, northeastern and western PA who filled a maintenance prescription drug in the last 120 days about the Active Choice Program by Express Scripts.
The purpose of the letter is to:
- Inform members who are taking maintenance prescription medications that they will need to make a choice on how to receive these medications.
- Provide cost savings and convenience examples supporting the home delivery choice.
Under the Active Choice program, a member must declare a choice to have their maintenance prescriptions filled either by home delivery through Express Scripts PharmacySM or to pick up their prescriptions at a local retail pharmacy.
Members have up to two fills at a retail pharmacy before they are required to make their choice. By the 3rd fill, the member will need to make a decision, or pay 100% of the drug cost. They will continue to pay 100% of the cost until their choice is made.
There is no penalty if members choose to continue to refill their maintenance prescription drugs through a retail pharmacy, and members can change their preference of retail pharmacy fills or mail order delivery at any time by contacting Express Scripts. Members will continue to get short-term medications, such as antibiotics, from participating retail pharmacies – no choice is required for short-term medications.