FAQs - Prescription Services - Scott & White

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Frequently Asked Questions

Why should I use generic medications?

Essentially, generic medications are brand-name drugs that have lost patent protection. All generic medications were at one time brand name drugs.

The Food and Drug Administration (FDA) still oversees all aspects of generic manufacturing, and generics must meet the exact same specifications as their brand name counterparts making them as safe and effective.

Generics also contribute to cost savings for you and your employer.

How are medications selected for the Preferred Drug List ?

The medication must be safe in order to be even considered.

To reduce the possibility of dangerous medications being added to the list, Scott & White has a policy that a medication must be available to the general market for a minimum of six months before it's included in the review process.

Secondly, each medication is reviewed and compared against other medications that treat the same condition. If all factors are the same, the most cost effective agent will be placed on the preferred drug list. However, this does not mean that high cost agents will be restricted from the list. If a medication is truly better, it will be added.

My medication is not on my employer's Preferred Drug List, what should I do?

If your physician is prescribing a medication not on your employer's preferred drug list, you have some options.

You can take a copy of your therapeutic category list to the doctor and ask that it be placed in your patient chart. This will increase the chances that your prescribing physician will choose a preferred medication. In almost every case, an agent to treat your condition will be on the preferred drug list.

In some cases, over-the-counter products may be your best option. You can consult your local pharmacist about some cost saving options.

And, of course, you can always get the medication your physician has prescribed and pay the higher copay amount.

What do the symbols on my employer's Preferred Drug List mean?

You will see several symbols on your preferred drug list, typically to the right of the name of the medication

A – means the medication is a generic and you will pay the generic copay amount
B – means that the medication is a brand name and you will pay the brand copay amount
M – means that the medication is considered a maintenance medication and qualifies for the maintenance benefit (i.e. three month supply for two copay amounts).
Usually this requires you to use the Wal-Mart mail order pharmacy in order to gain this benefit.
Maintenance drugs are coded as such if they meet the following criteria:
- Medications that do not require frequent monitoring and dosage adjustments for side effects or therapeutic responses.
- Certain drugs that may have potential life-threatening toxicity when taken as an intentional overdose may be excluded.
- Medications that are used to treat a chronic condition with no therapy endpoint. These drugs are taken continuously but do not provide a cure for the condition for which it is being treated.
- Medications that are typically used as outpatient type of drugs.
P – means the drug requires prior-authorization, meaning that your physician needs to communicate with us regarding medical necessity before your prescription can be filled for a copay by your pharmacy
S – means that to receive coverage you may need to first try a proven, cost-effective medication before "stepping" to a more costly treatment, if necessary.

The dollar symbols ($$) indicate relative cost to your employer, not your copay amount. This is important for you because your employer is self-funded, meaning that your premiums and the money the employer pays on your behalf pay all the claims. As claim amounts increase over time, premiums usually have to increase.

What if I prefer to take the brand instead of the generic?

Many employers allow employees to take a brand drug when a generic is available, but in most cases, the employee will pay a higher cost for this.

How do I use Wal-Mart mail Order?

Follow the instructions on the Mail Order page.

What is my Scott & White Prescription Service's PCN number?

02500000

What is my Scott & White Prescription Service's BIN number?

610141

How do I receive a copy of my prescription records?

Fill out a release of pharmaceutical information form PDF document and either fax it to 254-298-6186 or mail to:

Attention: Reporting Department,
Scott & White Prescription Services,: 4236 Lowe's Drive; Temple, TX 76502

How do I seek reimbursement for covered medications?

Fill out a direct member reimbursement form PDF document and either fax it to 254-298-6186 or mail to:

Attention: Customer Services Department,
Scott & White Prescription Services,: 4236 Lowe's Drive; Temple, TX 76502

How do I access my prescription benefit information online?

Scott & White Prescription Services has a web link called Member Access which contains many features that are beneficial to our members.

To enter the Member Access component, each member must initially register. Once registered, you are able to access your prescription benefit information, such as claims history, copay structure, deductible (if applicable) and drug information and interactions.

Members also have access to information on medications used to treat specific medical conditions and are also able to search for an in-network pharmacy.

For questions or assistance, you can contact our customer service department at 800-728-7947.

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