Your Cigna Prescription Drug Plan
When you enroll in a Cigna Medical Plan, you automatically receive prescription drug coverage through Cigna. Prescription drug coverage is the same for all Cigna medical options.
All Plans:
- Cover the same medications.
- Offer prescriptions through retail pharmacies and a mail-order service, Express Scripts Pharmacy Home Delivery.
- Provide the highest benefit for generic drugs, a lesser benefit for preferred brand drugs and the least benefit for non-preferred brand drugs.
- Require prior authorization before some medications can be dispensed.
- Offer certain preventive generics at $12 copay without meeting a deductible.
- Maintenance drug products must be filled in an amount equal to a consecutive 90-day supply per prescription order or refill at a retail Pharmacy or home delivery Pharmacy. This requirement applies after a 3 fill limit on 30-day supplies is reached for some maintenance medications.
Resources
- Cigna 3-Tier Rx Drug List (Select Drug Lists for Employer Plans, then select 3 Tier under Cigna Standard Prescription Drug List)
- Cigna Integrated Pharmacy Benefits Brochure
- Cigna Pharmacy Video
- Rx Price a Medication Tool
- Cigna 90 Now (90-day Rx)
- Cigna 90 Now Pamphlet
- Cigna 90 Now Directory
- 5 Ways to Save on Rx
- Pathwell Specialty Program
- Pathwell Specialty Drug List_2024
Forms
Rx Drug Home Delivery/Mail Order
Express Scripts Pharmacy Home Delivery Mail-Order Program Can Help You Save Time and Money
- You must use the Express Scripts Pharmacy home delivery program or a retail 90 pharmacy to refill your maintenance medications for them to be covered by the Plan (this includes oral contraceptives). A maintenance medication is prescribed for a chronic condition and must be taken on a regular basis, usually six months or longer.
- You can obtain up to three 30-day fills of maintenance medications at a retail pharmacy. Any refills at a retail pharmacy after the three-fill maximum won’t be covered by the Plan.
- After the three-refill retail maximum, you must switch to a 90-day supply through Express Scripts Pharmacy Home Delivery or to a retail-90 pharmacy to receive coverage.
Consider Filling Your Maintenance Drug Product Through Express Scripts Pharmacy Home Delivery
- Prescriptions are delivered right to you-no need to run out to the drugstore.
- You save money because the same 90-day prescription refill costs less through Cigna Home delivery than through a retail pharmacy.
- Regular refill reminders keep you on track with your medications, which is good for your health.
- You have access to all the services available through a retail pharmacy, including medication coaching, quality control, and a team of registered pharmacists filling your prescription.
How to Switch to Home Delivery
Switching to home delivery is easy. Call Express Scripts Pharmacy at 1-800-835-3784. They will contact your doctor’s office to help you transfer your prescription. Have your Cigna ID number, prescription medication names, doctor’s name and telephone number, and your credit card ready. You can also go to my.cigna.com/choosehomedelivery and follow the online instructions for how to move your prescription(s) to home delivery. If you prefer, you may contact your doctor’s office. Ask them to send a 90-day prescription (with refills) electronically to Express Scripts Home Delivery.
Resources
Insulin Cost Cap Patient Assurance Program (for Cigna Enrollees)
The Patient Assurance Program helps make certain medications more affordable – making it easier to stay on track with the medications that keep you healthy. Through the program, eligible medical option participants with diabetes can fill an eligible medication and pay no more than $25 for a 30-day supply, or no more than $75 for a 90-day supply, out-of-pocket.
Resources
Step Therapy (for Cigna Enrollees)
Step Therapy is an important part of your prescription drug coverage. It helps manage costs associated with certain high-priced brand name medications where generics or less costly brand-name drugs often work just as effectively.
Step Therapy applies to medications used to treat high blood pressure or cholesterol and stomach acid/ulcers. For these conditions, there are several medication choices that are proven to be safe and effective.
When one of those conditions can be treated successfully with a less expensive, therapeutically equivalent medication, it makes sense to choose the medications that offer appropriate care at the lowest out-of-pocket cost. The Plan encourages you to do so and if you choose not to use the equally effective and less expensive medication, the Medical Plan will not pay benefits for the medication.
RX Savings Solutions (for Cigna Enrollees)
Rx Savings Solutions is an easy, online benefit tool designed to help you save money on prescription drugs. This tool complements your current SBD prescription drug plan, notifying you of Rx savings opportunities and providing live support to facilitate a change to lower cost prescriptions. Access the website, myrxss.com, on your computer or mobile device and register to get started.
With Rx Savings Solutions, you can:
- Locate better prices for your prescription drugs at pharmacies near you.
- Identify different medications that perform the same as your current or prescribed medication, but with a lower out-of-pocket price (which you can review with your clinician or prescriber).
- Search and compare prices and other options before being prescribed a new medication.
- Learn how to speak with your doctor or prescriber about making any changes to your prescriptions. Or, Rx Savings Solutions can do the work for you – it provides access to certified pharmacy technicians for personal assistance.
- Easily see all the ways you can save money on your personal prescriptions, according to YOUR health plan.
Special Savings Notes: Be sure your spouse/domestic partner and adult-aged family members who are on your health plan set up their own accounts. Any minors’ prescriptions will appear on your own portal.
Questions? The Rx Savings Solutions Pharmacy Support Team is staffed with Certified Pharmacy Technicians who are available to assist with prescription questions at no cost to you. They can be reached Monday-Friday from 7:00 a.m. to 8:00 p.m. CT at 1-800-268-4476 or support@rxsavingssolutions.com.
Resources
- RxSS Saving Money on Prescriptions FAQ
- RxSS Mobile App
- RxSS Portal Demo // Demostración del portal RxSS
Your Kaiser Prescription Drug Plan
When you enroll in a Kaiser medical plan, you automatically receive prescription drug coverage. Note: You must reside in a eligible zip code.
