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Prescripti​on Drug Coverage

When you enroll in either of the Ingredion Medical Plan options, you automatically receive prescription drug coverage through Express Scripts.

You choose to have prescriptions filled either at a retail pharmacy or through mail-order (for 90-day supplies only). You save money if you choose to 
fill via the mail-order program. The amount you pay for a prescription depends on the medication – generic, formulary brand or non-formulary brand. Generic drugs are the least costly category of drugs. Your prescription drug coverage information is located on your BCBS medical ID card. There is no separate ID card for prescription drug coverage. Express Scripts will send a welcome kit to your home which provides more details on the prescription program. 

Rx Plan FeatureHSPHRP

​Preventive drugs are not subject to the deductible

Prescriptions are not subject to the deductible (preventive or non-preventive)

Non-preventive drugs are subject to the deductible

 Retail (30 day supply)Generic $10 copay
Formulary 20% coinsurance ($30 min/$90 max)
Non-formulary 50% coinsurance ($80 min/$240 max)
 Mail-Order (90 day supply)Generic $20 copay
Formulary 20% coinsurance ($75 min/$225 max)
Non-formulary 50% coinsurance ($200 min/$600 max)

 Do my drug expenses count 
 toward the Out-of-Pocket Max?

Yes, regardless of type of prescription (preventive or non-preventive)
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1 866 877 8492


ESI Registering Online or with the Mobile App
ESI Rx Claim Form
ESI Rx Drug Quantity Management Flyer
ESI Rx Getting Started with Home Delivery
ESI Rx Prior Authorization Flyer
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