Prescription Drug Benefit

Health plan members can purchase 90-day supplies of eligible medications at CVS pharmacies. Please see the copay rates listed below. 

Most prescription medications are also available by mail order through Express Scripts with no additional charge for shipping. You can purchase up to a 90-day supply for many of these medications. You will be required to pay the 90-day supply copay if you are purchasing between a 31 and 90 day supply, unless limited by drug dispensing rules. The only exception on this is for certain specialty drugs.

Some of your prescriptions may already be available through Express Scripts mail order — visit Express Scripts and click on the "prescriptions" tab to find out. Transfer additional prescriptions to Express Scripts by contacting your prescribing clinician; ask the clinician to send an up-to-90-day prescription to Express Scripts.

You are eligible for the Prescription Drug Benefit if you are paid by MIT, are appointed to work at MIT for at least three months, work at least 50% of the normal full-time work schedule, and are enrolled in either of MIT's health plans.

Who is eligible

• you have been appointed—and are currently employed—to work at MIT for at least three months
• you work at least 50% of the normal full-time work schedule
• you are paid by MIT
• you are enrolled in a health plan through MIT

Who is not eligible

• contractor
• affiliate
• teaching or research assistant (see graduate student benefits)
• honorary lecturer
• summer appointment
• international visiting student
• member of the armed services assigned to MIT
• family member who is not employed by MIT
• work-study student
• paid by MITemps

Members of collective bargaining units

All the plan provisions are subject to the terms of your collective bargaining agreement.

• Tier 1 drugs—Generic
  Medications that have exactly the same active ingredients as their brand-name counterparts. Your costs will be lowest when you choose Tier 1 drugs.
• Tier 2 drugs—Preferred brand
  Brand-name medications that are on a list of preferred drugs (also referred to as the Preferred Formulary List available below) that have been approved by a panel of doctors and pharmacists as safe, effective, and less expensive than other alternatives. You will pay more for Tier 2 drugs than Tier 1 drugs.
• Tier 3 drugs—Non-preferred brand
  Brand-name medications that have not been identified as an effective, lower cost medication on the formulary list. Your costs will be highest when you choose Tier 3 drugs.

FDA-approved birth control prescription drugs and devices are covered with no co-pay.

Use the table below to determine your cost or copayment.

COVID-19 Home Tests from Express Scripts

You can use your Express Scripts pharmacy benefit for up to four at-home COVID-19 tests per member, per month at a $0 copay. This applies to all MIT health plan members; MIT High Deductible Health Plan members do not need to meet the deductible first.

There are two ways to take advantage of this benefit:

At-Home COVID-19 Tests from a Pharmacy

1. Find a participating pharmacy: sign into your Express Scripts account (register first; you will be prompted for your member ID, which is your nine-digit MIT ID number).
2. Once signed in, click on Prescriptions at the top of the page, then Find a Pharmacy. Enter your zip code for a list of participating pharmacies close to you.
3. Bring your tests to the pharmacy counter (not the general check-out register) and present your prescription benefit card to the pharmacist. The pharmacist will process the test for a $0 copay.

If the COVID-19 test does not process for $0 copay at the pharmacy (and you have not used your allotment of four tests per month), save the pharmacy receipt. You can submit a paper claim form for reimbursement; fax or mail the form and the pharmacy receipt to receive reimbursement.

At-Home COVID-19 Tests Shipped Directly to Your Home

1. Sign into your Express Scripts account (register first; you will be prompted for your member ID, which is your nine-digit MIT ID number).
2. Once signed in, you will see an option at the bottom right side of the screen to select “Order At-Home COVID-19 Tests.”
3. Enter the requested information, and Express Scripts will mail your tests directly to your home address on file.

If you have any questions regarding the above processes, please contact Express Scripts directly at 866-454-7118.

COVID-19 Home Tests from the Federal Government

The federal government is distributing another round of four COVID-19 home tests per household, which can be ordered from the US Postal Service.

A Note on Expiration Dates

Many COVID-19 home tests have been approved for use after initial expiration dates. If you have unused tests at home that are beyond their printed expiration date, check this site to see if they can still be used.