Express Scripts: Insurance Carrier Or Not?

Express Scripts is a pharmacy benefit management (PBM) organisation. It is not an insurance carrier, but it does offer pharmacy benefit management services for workers' compensation insurance programs. Express Scripts provides integrated pharmacy benefit management services, including network-pharmacy claims processing, home delivery pharmacy services, and benefit-design consultation. It processes pharmaceutical claims for members through a network of retail pharmacies and offers discounted prescriptions to members anywhere in the country.

Express Scripts is a pharmacy benefit management (PBM) organisation

PBMs are responsible for developing and maintaining formularies, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims. They operate inside integrated healthcare systems, as part of retail pharmacies, and as part of insurance companies.

Express Scripts is one of the largest PBMs in the US, serving 180 million enrollees as of 2016. It is an independent, publicly-traded company that provides prescription drug benefits to consumers on behalf of health insurers, employers, and other healthcare payers.

PBMs work to increase access to prescription drugs and treatments while lowering drug costs. They develop and maintain their own networks of pharmacies, including retail, local, mail-order, and specialty pharmacies. PBMs also employ clinical experts and pharmacists who coordinate care and monitor prescriptions for interactions, helping to ensure that medications are used safely and as directed.

By negotiating rebates and discounts, PBMs can save consumers and payers between 40% and 50% on prescription drugs and related medical costs. They play an important role in increasing access to safe and effective medications while advocating for lower prices.

It provides integrated pharmacy benefit management services

Express Scripts is a pharmacy benefit management (PBM) organisation. It is not an insurance carrier, but it does provide integrated pharmacy benefit management services.

Express Scripts' services include network-pharmacy claims processing, home delivery pharmacy services, and specialty pharmacy benefit management through its subsidiary, Accredo. The company processes pharmaceutical claims for members through a network of retail pharmacies and its own automated pharmacies, which dispense medications directly to members via home delivery. This is a particularly useful service for those with chronic long-term diseases, such as diabetes or heart disease.

Express Scripts also offers benefit-design consultation, drug-utilisation review, formulary management, and medical and drug data analysis services to manage drug plans for health plans, self-insured employers, and government agencies. The company's clients include the United States Department of Defense's Tricare program, as well as workers' compensation insurance programs.

Express Scripts helps its customers to obtain the right medication from recommended pharmacies in their plan for the lowest possible price. The company works with drug makers and pharmacies to negotiate lower prices at the counter. Customers can also save time and money by having their medications delivered directly to their homes, and they can manage their prescriptions online or through the Express Scripts mobile app.

Express Scripts offers a prescription plan (also called a pharmacy benefit)

Express Scripts is not an insurance carrier, but it does offer a prescription plan, also called a pharmacy benefit. This plan covers prescription medications and supplies. Members can manage their prescriptions online or through the Express Scripts mobile app, which allows them to order medications, track their delivery, and connect with pharmacists 24/7.

One of the key benefits of the Express Scripts prescription plan is home delivery. Members can receive 3-month supplies of long-term medications delivered right to their door with free standard shipping. This service is safe and confidential, ensuring that medications are packaged securely and with any necessary temperature controls.

Additionally, Express Scripts offers discounted prescriptions through its network of pharmacies across the country. This is especially advantageous for members who travel or live in different states, as they can access their prescription benefits anywhere.

The Express Scripts prescription plan also provides cost savings. Members can save up to 32% on their prescriptions compared to retail pharmacies. Depending on the specific plan, preventive medications may also have low or $0 copays.

Overall, the Express Scripts prescription plan offers convenience, accessibility, and cost savings for its members, providing stress-free prescription delivery and world-class pharmacy care.

It is a subsidiary of Bloomfield, Connecticut-based Cigna

Express Scripts is a pharmacy benefit management (PBM) organization. It is a subsidiary of Bloomfield, Connecticut-based Cigna, a health insurance company. In 2017, Express Scripts was the 22nd-largest company in the United States by total revenue and the largest PBM in the country.

Express Scripts provides integrated pharmacy benefit management services, including network-pharmacy claims processing, home delivery pharmacy services, and specialty pharmacy benefit management. The company processes pharmaceutical claims for members through a network of retail pharmacies and offers mail-order delivery and a mobile app.

On March 7, 2018, Cigna announced it would be acquiring Express Scripts in a $67 billion deal. The acquisition was finalized on December 20, 2018, for $54 billion, allowing Cigna to begin offering new Express Scripts products to its corporate health insurance customers in 2019.

The acquisition of Express Scripts by Cigna was expected to drive greater affordability and improve links within healthcare and prescription services, while simplifying healthcare for customers. The combined company would use a network of "delivery system partnerships" to connect individuals with healthcare providers, providing a more coordinated approach to healthcare.

The integration of Cigna and Express Scripts also aimed to bring together the management of drug and medical benefits, potentially helping to control healthcare costs. The merger created a healthcare entity with revenues exceeding $140 billion.

Express Scripts offers mail-order delivery and a mobile app

Express Scripts is not an insurance carrier. However, it does offer mail-order delivery and a mobile app.

Mail-Order Delivery

Express Scripts offers home delivery for prescription medications, sending medication right to your door. This service includes free standard shipping and flexible payment options. Members can get 3-month supplies of long-term medications delivered quickly, safely, and accurately. Members can also save 32% on their prescriptions compared to retail pharmacies.

Mobile App

The Express Scripts mobile app allows members to manage their prescriptions anytime, anywhere. The app enables users to refill prescriptions, track orders, check medication prices, and make payments. It is available on the iOS App Store and Google Play Store. The app has received positive reviews, with ratings of 4.8 stars on both platforms.

The app provides easy access to a range of features, including finding a preferred pharmacy, checking order status, and accessing pharmacy benefits. However, it is important to note that the app requires an Express Scripts prescription benefit plan through health insurance or a plan sponsor.

By offering mail-order delivery and a user-friendly mobile app, Express Scripts provides convenient and accessible services to its members, allowing them to manage their prescriptions efficiently and save time and money.

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