PfISD's pharmacy benefit services is provided by Express Scripts administered by RxBenefits, Inc. There are more than 60,000 pharmacies in the Express Scripts network.
You have a separate pharmacy ID card that you must use when filling your prescriptions. Dependent names do not appear on the card. For lost cards you may use the attached temporary Express Scripts ID card and then you must also contact RxBenefits at 1-800-334-8134 to request a permanent card.
The summary of benefits includes information on your co-pay amounts, specialty medications and your maximum out of pocket limits. Summary of Benefits
Click on the link below to find a participating pharmacy, drug look up and list of exclusions and alternatives.
Some drugs listed on formulary may not be covered even if listed under preferred alternative due to the plan exclusions. Exclusions include:
- Biological, blood products, serums and Non-ACA immunization agents
- Cosmetic agents: Anti-wrinkle agents, Pigmenting & De-Pigmenting, Hair growth stimulants and hair removal products
- Compounded prescriptions
- Nutritional Supplements
- Infertility Medications
- Impotency Medications
- Prescription Vitamins unless listed above
- Anabolic Steroids
- Anti-obesity/Appetite Suppression Medications
- Formulary Exclusion List
- OTC (over the counter) Products unless noted above
- Therapeutic devices or appliances unless listed as a covered product.
- New to market drugs, including line extensions and new strengths until clinically reviewed
- Medication which is to be taken by or administered to an individual, in whole or in part, while he or she is a patient in a physician’s office, licensed hospital, rest home, sanitarium, extended care facility, convalescent hospital, nursing home or similar institution which operates on its premises, or allows to be operated on its premises, a facility for dispensing pharmaceuticals.
- Patient assistance programs may not apply to deductible and out of pocket accumulations.
If you are currently using a home delivery pharmacy, and would like to continue the convenience of having your prescriptions delivered, have your physician call in the prescription to the number on the back of your Express Scripts ID card and RxBenefits will do the work for you.
Register online at www.Express-Scripts.com and you will have a powerful tool to help you lower your prescription costs and save time. The member services department can be reached at 1-800-344-8134, or by email at RxHelp@rxbenefits.com from 7:00 am – 6:00 pm CST Monday through Friday.
Formulary Update - Effective 1.1.2022
Employees can contact Client Services at (866) 769-5987 or email at email@example.com