Prescription & Drug Coverage

Prescription coverage is included with both of our health plans and is processed by Express Scripts.

Base Plan
The prescription deductible for the base health plan is $125 per covered member, with out-of-pocket maximums of $1,600 per person, or up to $2,800 for family plan participants. Prescription co-pays under the base plan are not applied toward the medical plan deductible or out-of-pocket limits.

High Deductible Health Plan (HDHP)
There are no co-pays under the HDHP. Employees with the HDHP will pay 100% of prescription charges until the deductible is met, at which point the plan pays 80% of eligible in-network prescription expenses until the out-of-pocket maximum is met. All out-of-pocket prescription charges are applied to the HDHP deductible and out-of-pocket limits.

The HDHP also provides generic preventive prescription benefits payable at 100%. See the list of covered generic medications here.

Pre-Authorizations/Account Help
Compound drugs in excess of $250 require pre-authorization. Get the list of drugs that require pre-authorization here.

To access your personal claims information, visit the Express Scripts website. You will need to activate your online account by clicking “Register” in the top left corner of the page. You can also call Express Scripts Customer Service at (866) 781-7533.

Visit Acadian Central for premium rates, deductibles, etc.

Get the App
The Express Scripts mobile app is like a pharmacy in your pocket. You can order refills, make payments and set up reminders to take your medication.

iOS AppAndroid App

Retail Pharmacies/Mail Order

See a list of participating pharmacies in your area by going to the Express Scripts website. You may be able to save on prescriptions by choosing mail order options from Express Scripts.

Rx Savings Solutions

Never pay too much for prescriptions again! Rx Savings Solutions is a simpler way to save money at the pharmacy by providing transparency into prescriptions costs and options, at no cost to you and your dependents. The easy-to-use website finds lower-cost options for the same prescription drugs you’re already using. Users of this service typically save an average of $517 on annual prescription costs.

It’s simple to get started. You’re already a member; you just need to activate your free account. Once you register, RxSS will show you every opportunity available to save money on your current prescription(s). You’ll receive alerts whenever RxSS finds ways to save money for the same treatment. You can also use the search portal to easily find the best prices and options for any prescription drug.

Get StartedRxSS FAQs

Save on Insulin

Coupons and savings options are available for Acadian benefits members in need of insulin. Patient assistance programs provide a way for members to reduce insulin expenses and promote effective diabetes management.

Assistance programs may be available for the following insulin brands. Click the links to learn more. Some conditions and qualifications will apply.

Free Flu Shots

There’s never been a more important time to get your flu shot. A flu shot is one of the most effective ways to prevent the flu and keep you and your family safe.

Acadian employees can get a free flu shot—administered by Acadian HSE staff—at the beginning of each flu season. Details about when and how to get the shot are posted to Acadian Central. You also have the option to get a flu shot from your doctor or a local pharmacy. Flu shots administered in a doctor’s office or retail pharmacy (CVS, Walgreen’s, etc.) are covered at 100% for all individuals covered under an Acadian health plan (including spouses and dependents).

The Centers for Disease Control and Prevention recommends that anyone over the age of six months get a flu shot each flu season (October – May). Some people have a higher risk for developing flu-related complications. If you have chronic conditions – such as asthma, heart disease, diabetes or chronic kidney disease – you should make getting the flu shot a high priority. The same is true for people who are 65 and older.

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