HUMAN RESOURCES at MIT

Pharmacy Benefit

Express Scripts (ESI) is the Pharmacy Benefit Management (PBM) Company for the MIT Health Plans administered through Blue Cross Blue Shield and Tufts. You and your eligible family members, who participate in these health plans through MIT, will have prescription drug coverage through ESI and will receive in a mailing from Express Scripts a separate ID card that will be required for prescription purchases.

Who Is Eligible

You are generally eligible for this Plan if you: (1) work at least 50% of the normal full-time work schedule in your department, laboratory or center; (2) are appointed to work at MIT for at least three months; (3) are paid by MIT; and (4) participate in either a Blue Cross Blue Shield Plan or Tufts Health Plan through MIT.

If you are a member of a collective bargaining unit, all the provisions of the Pharmacy Benefit Plan are subject to the terms of your collective bargaining agreement.

Benefit

The Plan covers certain eligible prescription drug expenses that are written by a Blue Cross Blue Shield or Tufts Health Plan physician. The Plan allows participants to receive their prescription drugs at participating pharmacies or by mail order.

How the Plan Works

  • If the medication is a generic medication, you will pay the co-payment amount indicated in the first column of the chart below.

  • If the brand-name medication is part of the Plan's formulary list, you will pay the Preferred Brand-Name co-payment amount indicated in the second column.

  • If the brand-name medication is not listed on the Plan's formulary list, you will pay the Non-Preferred Brand-Name co-payment amount indicated in the third column.

  Generic Preferred Brand Name Non-Preferred Brand Name

Retail Pharmacy
(up to a 30 day supply)

$8.00

$25.00

$40.00

Mail Order
(up to a 90 day supply)

$16.00

$50.00

$80.00

Enrollment

If you enroll in either a Blue Cross Blue Shield Plan or Tufts Health Plan, your pharmacy benefit enrollment will automatically be sent to Express Scripts. You will not be required to submit a separate enrollment.

This information is intended to be a summary of the Plan. The Plan document (available from the Benefits office) contains all the details. If there is a conflict between this summary and the Plan document, the Plan document will control.

MIT expects to continue the Plan as a benefit to employees, but reserves the right to change or terminate the Plan should this become necessary or advisable.

Forms & Publications