Express Scripts Prescription Drug Plan for Both Actives & Retirees

Given the fluctuating nature of the economy and rising costs of goods and services, the DEA Health Benefits Trustees found it necessary to implement a few modifications to the DEA Health Benefits Funds. Letters which went out to the retired and active members of the union reiterating the following:

Effective September 1, 2025, the current co-pay structure for generic medications increased from $0 co-pay to $5 per generic prescription for all active members and covered dependents.

Effective September 1, 2025, there has been a reinstatement of the annual deductible of $50 per retired member and each covered dependent.

Effective September 1, 2025, there has been a reinstatement of a $10 co-payment for all retired members and covered dependents on generic medications purchased at either retail pharmacies or through a mail-order program.

Coinsurance for all retired members and covered dependents on “preferred” brand name medications purchased at either retail pharmacies or through the mail-order program increased from 30% to 35%.

Coinsurance for all retired members and covered dependents on “non-preferred” brand name medications purchased at either retail pharmacies or through the mail-order program increased from 30% to 40%.

Coinsurance for all retired members and covered dependents on “specialty” medications purchased at either retail pharmacies or through the mail-order program increased from 30% to 50%.

Please know that we are sensitive to the impact this may have on you and your family; however, the Trustees will continue to explore cost-savings options in all benefit areas to reduce costs in the future.

EXPRESS SCRIPT ACTIVE – SUMMARY

EXPRESS SCRIPTS RETIREE SUMMARY

HERE’S THE BACKSTORY:

Effective February 1, 2023, the DEA launched a new prescription drug program with Express Scripts. This new program replaces our Benecard prescription drug plan. Our members should experience significantly enhanced prescription drug benefits with no disruptions to current prescription drug needs. Members should have received a “welcome kit,” which includes a letter and your new pharmacy ID cards. This replaces your Benecard card only. (Continue to use your PICA and/or WTC Health Program card(s) as you currently do now, as the new Express Scripts card will not replace those cards, although Express Scripts will be able (behind the scenes) to view and direct your prescription needs to the correct PICA and the WTC benefit providers.) Present your new prescription card to your pharmacy.

This new plan will save the DEA health benefits funds approximately $20-million over three years: money which we can use to enhance other health benefits.

For Actives —The annual out-of-pocket maximum is lowered to $5,000 Individual / $10,000 Family. And once this is met, 100% of prescription costs are covered by the Fund. There is no family spend limit on medications.

For Retirees — The annual family maximum benefit is increased to $20,000. There is no annual deductible. Generic copay (retail and mail) is lowered to $5.

The DEA has a dedicated Express Scripts Customer Service number at (877) 882-3343.

Express Scripts also has enhanced website and mobile app capabilities that members can use to manage their mail order medication refills, review drug costs, and view your ID card. You can register and set up your online account at express-scripts.com

Download the mobile app on the App Store or Google Play.