Prescription Drug Benefit

Prescription Drug Benefit

Members of MIT Traditional and MIT Choice Health Plans can use the MIT Pharmacy to fill prescriptions written by MIT Medical care providers or by an outside clinician if referred by an MIT Medical care provider.

Eligibility

You are eligible for the Prescription Drug Benefit if you are paid by MIT, are appointed to work at MIT for at least three months, work at least 50% of the normal full-time work schedule, and are enrolled in either of MIT's health plans.  Learn more about eligibility.

Next steps

  1. Confirm your eligibility.
  2. Review prescription drug benefit details below.
  3. Locate a participating pharmacy (login required)

The Prescription Drug Benefit

You and your eligible family members are automatically enrolled in a prescription drug plan managed by Express Scripts (ESI) when you sign up for MIT health coverage. The benefit provides a variety of cost savings for eligible prescription drug expenses when they are prescribed by a plan doctor. You can obtain your medications by mail or at retail pharmacies that belong to your health plan's network.

  • When you use an ESI network pharmacy, you can purchase up to a 30-day supply of your medications.
  • When you order through the mail, you can order up to a 90-day supply of your medications.

More on Eligibility

Who is eligible

  • you have been appointed—and are currently employed—to work at MIT for at least three months
  • you work at least 50% of the normal full-time work schedule
  • you are paid by MIT
  • you are enrolled in a Health Plan through MIT

Who is NOT eligible

  • contractor
  • affiliate
  • teaching or research assistant
  • honorary lecturer
  • summer appointment
  • international visiting student
  • member of the armed services assigned to MIT
  • family member who is not employed by MIT
  • work-study student
  • paid by MITemps

Members of collective bargaining units

All the plan provisions are subject to the terms of your collective bargaining agreement.

How it Works

If you are eligible for the Prescription Drug Benefit, Express Scripts (ESI) will send you an ESI ID card automatically. The amount you save depends on

  • how you fill your prescription—by mail or through an ESI network retail pharmacy
  • which tier of drug you purchase
    • Tier 1 drugs—Generic
      Medications that have exactly the same active ingredients as their brand-name counterparts. Your costs will be lowest when you choose Tier 1 drugs.
    • Tier 2 drugs—Preferred brand
      Brand-name medications that are on a list of preferred drugs (also referred to as the Preferred Formulary List available below) that have been approved by a panel of doctors and pharmacists as safe, effective, and less expensive than other alternatives. You will pay more for Tier 2 drugs than Tier 1 drugs.
    • Tier 3 drugs—Non-preferred brand
      Brand-name medications that have not been identified as an effective, lower cost medication on the formulary list. Your costs will be highest when you choose Tier 3 drugs.

Your cost

Use the table below to determine your cost or copayment.

MIT Traditional Plan
   Tier 1—Generic Tier 2—Preferred Tier 3—Non-Preferred
30 day supply 90 day supply 30 day supply 90 day supply 30 day supply 90 day supply
MIT Pharmacy* $5.00 $10.00 $15.00 $30.00 $40.00 $80.00
Express Scripts Network $8.00 $16.00 $25.00 $50.00 $40.00 $80.00

 

MIT Choice Plan
   Tier 1—Generic Tier 2—Preferred Tier 3—Non-Preferred
30 day supply 90 day supply 30 day supply 90 day supply 30 day supply 90 day supply
MIT Pharmacy* $5.00 $10.00 $15.00 $30.00 $40.00 $80.00
Express Scripts Network $8.00 $16.00 $25.00 $50.00 $40.00 $80.00

* Note: Members of the MIT Choice Plan can fill prescriptions at the MIT Pharmacy ONLY if written by an MIT Medical provider.

Filling your prescriptions by mail

The Express Scripts (ESI) mail service pharmacy provides

  • home delivery of your prescription medications, including the option for automatic refills
  • patient education materials
  • toll-free phone consultation with patient-care advocates and registered pharmacists

Use ESI's Home Delivery Guide (below) to fill your prescriptions by mail. Be sure to allow 14 days for the delivery of your first mail order. You can reach ESI's Patient Contact Center 24 hours a day, 365 days a year at (800) 698-3757.

What Else You Should Know

  • 90-day supplies of medications are available only through the MIT Pharmacy or through Express Scripts mail order, and not from a retail pharmacy.
  • FDA-approved birth control prescription drugs and devices are covered with no co-pay.

Learn More

Read more about the prescription drug provisions of the MIT Health Plans.