# Prescriptions ## Prescriptions HUGHP offers a prescription drug benefit through Express Scripts. With the Express Scripts® Mobile App, you can manage your medication anytime and anywhere. Refill your prescriptions, track orders, check medication prices, find a pharmacy, and more. [ Learn more about the Express Scrips mobile app arrow\_circle\_right ](/resource/express-scripts-evernorth) ![Pharmacist reaching for medication.](/sites/g/files/omnuum11506/files/styles/hwp_21_9__1920x825/public/hughp/files/pharmacist.jpg?itok=6SeMyi6d) ### On this Page: - [Copayments for Prescriptions](/prescriptions#copayments-prescriptions) - [How and Where to Fill Prescriptions](/prescriptions#how-fill-prescriptions) - [Specialty Prescriptions](/prescriptions#specialty-prescriptions) - [PillarRx Specialty Drug Copay Assistance Program](/prescriptions#pillarrx-assistance-program) - [GLP-1 Medication Changes](/prescriptions#glp1-medication-changes "Prescriptions") - [Prescriptions & Travel](/prescriptions#prescriptions-travel) --- ## Your Prescription Drug Coverage When you fill a prescription, the copayment you pay at the pharmacy is determined by the tier your medication falls into. Medications are placed on tiers according to a variety of factors, including what they’re used for, their cost, and whether equivalent or alternative medications are available. A copayment is the set price you pay for up to a 30-day supply of your prescription drug. You pay the copayment even if your physician prescribes less than a 30-day supply of your medication. ### Copayments for Prescriptions SortTierUnion PlansNon-Union Plans**Tier 1:** Most generic drugs $7 $10 **Tier 2:** Preferred brand-name drugs $20 $25 **Tier 3:** Non-preferred brand-name drugs $45 $55 Limitations and restrictions may apply to certain medications. Some drugs may also require a pre-approval process between the doctor's office and Express Scripts. [**View the 2025 Prescription Drug Copayments**](/prescriptions#2025-prescription-copayments) ### Look up Your Prescription Copayment Estimate Visit [**Express Scripts Pharmacy Benefit Estimate Tool (express-scripts.com)**](https://www.express-scripts.com/frontend/open-enrollment/HarvardUniversity?r=expressscripts_com) and follow the instructions below. - Select the HUGHP plan that applies to you (HUGHP HMO POS Nonunion, HUGHP HMO POS Union, or HUGHP POS Plus Nonunion) and click “View Details” - Select the “Price a Medication” box - Type in the name of the medication and provide all information that is listed in the boxes below the medication box tool **Note:** Information provided on the Express Scripts website is an estimate only. ### Preventive Medication List [**Certain medications**](https://www.express-scripts.com/files/hub/art/open_enrollment/PlusPreventMedList.pdf) used to prevent or manage the treatment of chronic conditions will be available at reduced or no cost. Examples of conditions that medications on this list may treat include asthma, high blood pressure, high cholesterol, and diabetes. For additional information, please see the [**preventive medications FAQs**](/file_url/279). ### Prescription Formulary Certain medications may change copayment tiers, may no longer be covered, or may move into a formulary management program (e.g., require prior authorization). If impacted, you will receive a letter from Express Scripts about the change in coverage. ### 2025 Prescription Drug Copayments expand\_more **Tier 1:** Most generic drugs - $7 **Tier 2:** Preferred brand-name drugs - $20 **Tier 3:** Non-preferred brand-name drugs - $45 Limitations and restrictions may apply to certain medications. Some drugs may also require a pre-approval process between the doctor's office and Express Scripts. --- ## How and Where to Fill Prescriptions ### 30-Day Supplies HUGHP members can fill prescriptions for a 30-day supply by presenting their Express Scripts ID card at any participating Express Scripts pharmacy in the United States. ### Up to 90-Day Supplies HUGHP members can fill prescriptions for a 90-day supply by presenting their Express Scripts ID card at the following pharmacies: - Any Atrius Health pharmacy for prescriptions written by an Atrius Health clinician - Any CVS pharmacy - Express Scripts Mail Order Pharmacy\*. To get started with the mail-order pharmacy, visit [**Express Scripts**](https://www.express-scripts.com/), and select Register. You can also call Express Scripts at 1-800-892-5119. ### 90-Day Mail Order Copayment Discounts If you choose to fill a 90-day prescription through Express Scripts mail order, you will receive a discount compared to purchasing three separate 30-day prescriptions. The 90-day (three months) discount is: SortTierUnion PlansNon-Union Plans**Tier 1:** Most generic drugs $14 $20 **Tier 2:** Preferred brand-name drugs $50 $60 **Tier 3:** Non-preferred brand-name drugs $110 $130 No discount applies to 90-day prescriptions obtained through Atrius Health or CVS locations. Members will pay three copayments for each 90-day prescription filled at these pharmacies. [**View the 2025 90-Day Mail Order Copayment Discounts**](/prescriptions#2025-mail-order-copayments-discounts) ### Information for Filling a Prescription When filling a prescription, you will need to provide the following to the pharmacist: **Prescription benefit through:** Express Scripts **Member ID:** If you have not received your Express Scripts ID cards, contact Member Services, or contact Express Scripts at (877) 787-8684 to order a new set. *Please note that only the name of the subscriber will appear on all ID cards.* **BIN:** 003858 **PCN:** A4 **Group:** HUGHPRX ### 2025 90-Day Mail Order Copayments expand\_more If you choose to fill a 90-day prescription through Express Scripts mail order, you will receive a discount compared to purchasing three separate 30-day prescriptions. The 90-day (three months) discount is: - Tier 1 - $14 - Tier 2 - $50 - Tier 3 - $110 No discount applies to 90-day prescriptions obtained through Atrius Health or CVS locations. Members will pay three copayments for each 90-day prescription filled at these pharmacies. --- ## Specialty Prescriptions Specialty medications are high-cost prescription drugs used to treat complex or chronic conditions. These medications often require special handling and administration and are carefully supervised by health care providers. Most specialty prescriptions must be purchased through an approved network Specialty Pharmacy. If you need to fill a specialty medication, you will either need to fill the medication through Accredo or Freedom Fertility (both through mail order). ### Accredo - Contact [**Accredo**](https://accredo.com/) to set up an account in order to get specialty medications delivered. - Have your prescribing doctor send your prescription to Accredo to be filled through [**Accredo Health Group, Inc.**](https://accredo.com/) or by calling (800) 803-2523 - Accredo will work with your doctor to get your prescription, and they'll contact your health plan about your benefits. - Accredo will call you to schedule free delivery to your home or doctor’s office1 on a date that works for you. They’ll ship your medication with any special handling it may need, such as refrigeration. - Once you receive your first order, register online to easily order refills,2 set up reminders, and get the status of your future shipments. 1. *As allowable by law.* 2. *Not available for all specialty medications.* ### Freedom Fertility Pharmacy Infertility prescriptions are filled by Freedom Fertility Pharmacy. - For general inquiries and information, contact Freedom's Patient Care Center by calling (800) 660-4283 or emailing [**help@freedomfertility.com**](mailto:help@freedomfertility.com). How to get started: - Ask your prescriber to fax your prescription to Freedom. - Contact Freedom to set up your order and schedule your delivery. Some specialty medications may be eligible for copay assistance through the [**PillarRX Copay Assistance Program**](/file_url/325). --- ## GLP-1 Medication Changes Beginning January 1, 2026, the coverage requirements will change for GLP-1 medications used for weight loss. The University is introducing a comprehensive weight management program called EncircleRx to support members using these medications for weight management. EncircleRx incorporates updated clinical criteria for coverage, along with an ongoing lifestyle modification program through 9amHealth. There will be no change to the coverage guidelines for GLP-1 medications used to treat diabetes. The following [**GLP-1 Clinical Change & Coverage Requirement FAQs**](https://harvie.harvard.edu/sites/g/files/omnuum12046/files/2025-10/GLP1_Clinical_Changes_FAQ.pdf) provide more details about these updates and what they mean for members. --- ## PillarRx Specialty Drug Copay Assistance Program Harvard University has partnered with the PillarRx Copay Assistance program to reduce your costs for certain specialty medications that you and/or your dependents may be taking. Specialty medications are high-cost prescription medications used to treat complex or chronic conditions. These medications often require special handling and administration and are carefully supervised by health care providers. This is a confidential program managed directly by PillarRx. PillarRx can help you secure financial assistance through drug manufacturers that will substantially reduce or completely cover your out-of-pocket costs for your specialty medication(s). Your Pharmacy benefit remains through Express Scripts and is not changed by this program. **Note:** - Manufacturer assistance dollars may not accumulate toward deductibles and/or out-of-pocket maximums. - Medications will still need to be filled through Accredo, the Express Script Specialty Pharmacy. - If you don’t enroll in the program, you will be responsible for up to 30% of the cost of the medication. ### How to get started: If you are prescribed an eligible medication, you will be contacted by a PillarRx Care Team Member to help facilitate enrollment in the manufacturer programs. They will: - Provide details about your current costs - Enroll you in the program or work with the drug manufacturer(s) to facilitate your enrollment - Secure savings for you and your family - Answer any questions you have about the program The program will then provide ongoing support to: - Work with your specialty pharmacy to facilitate refills and manage your negotiated out-of-pocket costs - Manage claims and ensure your financial assistance is processed as expected - Work with you and your family/caregiver to manage ongoing communication with the drug manufacturer(s), specialty pharmacy, and your health plan You will receive a call from a PillarRx Care Team Coordinator to start the process. If you do not receive a call or if you have any questions about the program, you can call them directly at (636) 614-3126. --- ## Prescriptions & Travel ### Traveling Within the U.S. You can fill or refill up to a 30-day supply of most prescriptions at any participating pharmacy in the United States. Your copayment(s) or drug benefits do not change. If you purchase medication without using your member ID card, you may file for reimbursement through Express Scripts. You will be reimbursed at the plan-allowed amount minus the applicable copayment. Submit a [**prescription drug claim form**](/file_url/274) to receive reimbursement. ### Traveling Outside the U.S. Prescriptions that are purchased out of the country are reimbursed at the plan-allowed amount minus the applicable copayment. Submit a [**prescription drug claim form**](/file_url/274) to receive reimbursement. [**Learn more about the Express Scripts mobile app**](https://express-scripts.com/mobile-app). ## Get Help phone [### Call Us ](/contact-us)(617) 495-2008: Mon-Fri, 9:00 am-4:00 pm Closed for lunch, 1:00 pm-2:00 pm email [### Email Us ](mailto:mservices@huhs.harvard.edu)Email your questions to us. laptop [### Meet With Us ](/contact-us)Email your availability to request a virtual appointment with Member Services.