Prescription Drugs
Patients with a primary care provider at MIT Medical may use the MIT Pharmacy to fill prescriptions written by MIT Medical providers or by an outside clinician if there is an approved referral on file from an MIT Medical provider. Using the MIT Pharmacy gives MIT Medical care providers a complete picture of your prescription history, which allows them to better coordinate your medical care. If the MIT Pharmacy does not stock a covered medication, MIT Pharmacy staff can obtain it from an outside contracted pharmacy.
Most prescriptions filled at the MIT Pharmacy have lower copayments. You can also obtain a 90-day supply of many prescriptions for the price of two 30-day refills. You can request refills by calling the Pharmacy at 617-253-0202 or by submitting a request online using Patient Online.
When the MIT Pharmacy is unavailable
If you are out of the area or you need to fill a prescription when the MIT Pharmacy is closed at night or on weekends, you can obtain up to a 30-day supply of most prescribed medications at any retail pharmacy in the Express Scripts network. Most major retail chains participate in this network. When using Express Scripts, you will usually have a higher copayment than at the MIT Pharmacy.
To find an Express Scripts pharmacy or to see if your medications are included in the Express Scripts formulary, visit the Blue Cross pharmacy coverage website. If you have questions about this coverage, contact Claims and Member Services at 617-253-5979.
The chart below details copays and limitations for the MIT Pharmacy and participating Express Scripts pharmacies for 2011.
| MIT Pharmacy copayment and limitations | Express Scripts copay and limitations | |
|---|---|---|
| Tier 1 copay | $5 for up to a 30-day supply | $8 for up to a 30-day supply |
| Tier 2 copay | $15 for up to a 30-day supply | $25 for up to a 30-day supply |
| Tier 3 copay | $40 for up to a 30-day supply | $40 for up to a 30-day supply |
| Supply limit | For many drugs, up to a 90-day supply for double the 30-day copayment | Limited to a 30-day supply per fill |
| Prescribing physician | Prescription must be written by an MIT clinician or by a provider to whom member was referred by an MIT clinician | No restrictions |
| Mental health prescriptions | Member must notify MIT Medical's Mental Health and Counseling service so a referral can be entered before prescription can be filled | No restrictions |
| Mail order | Available through MIT Pharmacy; request can be submitted through Patient Online | Available through Express Scripts; 90-day supply available with a 60-day copay for most prescriptions |
Important: If your primary care provider is at MIT Medical, you must fill all prescriptions at the MIT Pharmacy or at a participating Express Scripts pharmacy. There is no reimbursement for drugs purchased by the member. This includes prescription drugs that are not on the MIT Pharmacy or Express Scripts formularies.
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