SHIP Prescription Drug Benefit

Eligibility and plan benefits will be determined at the time of service or upon receipt of the claim.  In addition, during academic breaks, we may be unable to confirm the student's eligibility prior to receipt of the spring, fall, or summer eligibility information.  We will provide a general description of the benefits only, it is not a guarantee of payment.  Benefits are based upon the master policy, medical necessity, and the patient's eligibility at the time of service.  If the participant chooses a brand name drug when a generic drug is available for new prescriptions and/or refills, the co-pay for the generic equivalent plus the difference in cost between the generic and brand name drug will be applied.

On-Campus at the
Student Health Pharmacy
Click on the link above for more information.

Off-Campus at In-network Providers

Print Proof of Insurance Card--print each semester
After logging in Select the current term and follow the instructions. 
Your Express Scripts (ESI) information is included on the card.

Benefits through Express Scripts (ESI)
The in-network prescription drug benefits program is separate from the medical benefits and is administered by Express Scripts (ESI). This program allows you to use your SHIP/ESI prescription drug benefit at a nationwide network of participating pharmacies to purchase your prescriptions. When purchasing prescription drugs at retail pharmacies using your SHIP/ESI Proof of Insurance at participating pharmacies provides you with the best economic benefit and the added convenience of paying a flat dollar co-payment. You will need to print your proof of insurance using the link above and provide it to the pharmacy with your prescription.	PRESCRIPTIONS AT IN-NETWORK PROVIDERS	COST
	cost is per prescription and limited to a 30 day supply
	Generic Formulary Drugs up to $20	retail cost
	Generic Formulary Drugs above $20	50% of retail cost ($20 min.)
	Brand Name Formulary Drugs up to $30	retail cost
	Brand Name Formulary Drugs above $30	50% of retail cost ($30 min.)
	NOTE: For a complete list of covered drugs and supplies, and applicable limitations and exclusions, please refer to the Express Scripts Drug Coverage List, which is incorporated by reference and is available below or by calling ESI at 1-800-955-4879.
	Claims for reimbursement of prescription drugs are to be submitted to Express Scripts at: Express Scripts Inc. P.O. Box 66773 Attn: Claims St. Louis, MO 63166-6773.

EXPRESS SCRIPTS CLAIM FORM

Express Scripts Formulary (Drug Coverage List)

Express Scripts In-Network Providers - Idaho

Express Scripts In-Network Providers - Washington

Express Scripts Out-of-Network Providers - National

Off-Campus at Out-of-network Providers

Electronic processing is not available at Out-of-Network providers.
NOTE: If you purchase your prescription drugs from a non-participating pharmacy, you will have to pay the full price of the prescription and then submit a claim for reimbursement. Reimbursement will be according to the network price, so your total out-of-pocket cost may be greater than the co-payment you would have paid if you had used a network pharmacy.	PRESCRIPTIONS AT AN OUT-OF-NETWORK PROVIDER cost is per prescription and limited to a 30 day supply	subject to deductible, coinsurance and exclusion provisions on pages 9 and 10 of the 2008-2009 SHIP Brochure
	Claims for reimbursement of prescription drugs are to be submitted to: Claims Administrator AmeriBen/IEC Group PO Box 7186 Boise ID 83707 Phone: 1-800-953-1801 Fax: 208-424-0595 For faster claims processing, provide insured student's social security number and the UI Group #0805014.