Mail Order for Maintenance Medications

2021 and 2022 Plan Year Information

Maintenance Medications and Mail Order

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.

Under Morgan Stanley’s prescription drug program, maintenance medications must be filled in a three-month supply through Express Scripts Home Delivery, CVS or Capsule Pharmacy. (If you currently take a maintenance medication or are prescribed one at any point, you will be notified by Express Scripts.) Filling these prescriptions in a higher quantity lowers your out-of-pocket costs an average of 28% compared to a one-month supply. If you do not transition to a three-month supply at one of the designated network pharmacies after three one-month fills, you’ll pay 100% of the cost of the drug starting with the fourth fill – and the cost will not count toward your annual deductible or out-of-pocket maximum.

You can also enroll in Express Scripts’ Smart90 program, which not only saves you money, but also gives you three convenient ways to get the prescription drugs you take regularly:

  1. Have Express Scripts mail your medications to your home or office (no cost for standard mail);
  2. Pick up your prescription in person at a CVS pharmacy; or
  3. Use Capsule Pharmacy’s free same-day delivery service (available in certain metropolitan areas)

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 Medical Plan Options A or B, your deductible is waived for mail order if you use mail order or the Smart90 program. For Medical Plan 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.

See what you pay for a 90-day supply of medication.

Mail Order (up to 90-day supply)
Generic Drugs

You pay $20 copay

Preferred Brand Drugs

You pay 30% coinsurance
($63 min, $112 max)

You pay 30% coinsurance
($65 min, $150 max)

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