If you are enrolled in a Morgan Stanley Medical Plan and take an ongoing medication, you may enroll to have your medication delivered to your home through your administrator’s mail order program. With mail order, you receive up to a 90-day supply for less money than the cost of three separate 30-day retail fills. Mail order saves you time and money.
2020 and 2021 Plan Year Information
Mandatory Mail Order
Employees taking maintenance medications are required to get 90-day supplies of those medications through mail order delivery or a participating retail pharmacy. OptumRx participating retail pharmacies include CVS and Target. The Cigna Retail 90 network includes CVS, Target, Walmart and Kroger along with other retail pharmacies. You will have three 30-day grace fills, per medication, at a retail pharmacy. If you have not enrolled in mail order or switched to a retail 90 pharmacy by the fourth fill, you will pay 100% of the cost of the medication. See the prescription drug FAQs for more information.
Maintenance medications are those you take on an ongoing basis for conditions such as diabetes, high blood pressure and high cholesterol, as well as birth control and certain behavioral health medications.
If you do not enroll by the fourth fill, you will be required to pay 100% of the cost of your medication, in addition to paying your deductible, and these out-of-pocket costs will not be counted toward meeting your deductible or out-of-pocket maximum.
How It Works
- Your doctor prescribes you a maintenance medication. If you are already taking an eligible maintenance medication, skip to step 2.
- Cigna Pharmacy or OptumRx notifies you that mail order is available to you.
- You have three grace fills (30-day) at a retail pharmacy before you must enroll in the mail order or retail 90 program. If your doctor decides to change your dose or brand, you will have another three fill opportunities before enrolling in the mail order program.
- If you are not enrolled in the mail order or retail 90 program by the fourth retail fill, you will have to pay 100% of the cost of the medication. This cost will not apply to your deductible or out-of-pocket maximum.
How to Enroll
Enrolling in the mail order or retail 90 program is easy and can save you time and money. OptumRx and Cigna Pharmacy advise which of your maintenance medications are eligible for mail order. You may enroll online at optumrx.com or mycigna.com or call a representative. Their representatives will contact your doctor directly to obtain the necessary prescription and contact you if your doctor does not provide the prescription.
If you currently have a mail order prescription that you want transferred to retail 90, simply bring an empty medication bottle or package with the prescription information to a participating retail 90 pharmacy and they can do the transfer for you. Alternatively, call OptumRx or Cigna to assist with the transfer.
How Much Does Mail Order Cost?
The amount you pay for maintenance drugs depends on your Medical Plan coverage option and the cost of the drug itself. If you enroll in Options A or B, your deductible is waived for mail order if you use mail order or retail 90. For Option C, you will not need to pay toward the deductible if the maintenance medication is also considered preventive. For non-preventive maintenance medications, you will be required to meet the combined medical and prescription drug deductible. The cost for maintenance medications at home delivery and participating retail 90 pharmacies will generally be similar.
|Mail Order (up to 90-day supply)|
You pay $20 copay
|Preferred Brand Drugs|
You pay 30% coinsurance
|Non-Preferred Brand Drugs|
You pay 40% coinsurance ($125 min, $300 max) for non-specialty drugs
You pay 40% coinsurance ($125 min, $400 max) for specialty drugs