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Pharmacy Benefits

The WTC Health Program contracted Express Scripts to provide prescription benefits for members with certified WTC-related conditions as the Pharmacy Benefit Manager (PBM). Express Scrips has approximately 62,000 pharmacies in their national retail pharmacy network including major retail pharmacy chains and independent pharmacies. Express Scripts provides home delivery and specialty pharmacy options for eligible WTC Health Program members.

Visit the Express Scripts Website for the latest news and to register for the Express Scripts Member Portal.

Create a new pharmacy benefit account on the Express Scripts website or through the Express Scripts Mobile App . The Express Scripts Member Portal allows you to check your prescriptions status, find your local in-network pharmacies, and track any home deliveries you may have.

If you have questions regarding your WTC Health Program pharmacy benefits you can contact Express Scripts directly at 1-800-935-7179.

The PBM recently transitioned from Optum to Express Scripts. You can find more information about the transition process on the PBM Transition webpage.

Responders: If you have WTC-related specialty prescriptions, you needed to switch those prescriptions to Accredo by September 1, 2022. You should have received a letter from Express Scripts with instructions. To fill specialty prescriptions online, track shipments, and access your plan information, visit the Accredo website or call 1-855-540-1780.

For Survivors: Coordination of Benefits

Coordination of Benefits is the process required to pay medical and pharmacy claims for WTC-certified Survivors with an eligible condition. To fully cover any medical and/or pharmacy costs for Survivors, the WTC provider must bill your primary insurance first, including any public insurance such as Medicare or Medicaid, and then bill the Program the remaining amount. This leaves no out-of-pocket cost to you.

Coordination of Benefits is a requirement for Survivors according to the James Zadroga 9/11 Health and Compensation Act of 2010 (Zadroga Act). Learn more on the Coordination of Benefits page.

Make sure that your Clinical Center of Excellence or Nationwide Provider Network has your updated primary insurance information to avoid issues processing coverage for your WTC-related medication(s).

Your Prescription Medicine: Tips for Safe Storage and Disposal

How and where you keep your medication can make a big difference when it comes to safety. Learn how best to store your medication, find where to dispose of unused or unwanted medication, and download an informative fact sheet or postcard for quick reference on the Prescription Safety page.

Still have questions?

Visit the Frequently Asked Questions (FAQs) or call Express Scripts at 1-800-935-7179. You can also learn more by visiting the Pharmacy Benefits section of the Member Handbook.