Pharmacy Benefits - Express Scripts (ESI)

Effective January 1, 2024, the management of University's pharmacy portion of Fordham’s health insurance plan has transitioned to Express Scripts Inc. (ESI), replacing UnitedHealthcare (UHC).

Why is the University changing its Pharmacy Benefits Manager (PBM)?
Over the last few years, the University has been steadily implementing fiduciary strategies aimed at improving the quality of care and service for its members, while slowing the rate of growth of the health plan cost.

Prior to January 1, 2024, the University had a “carved-in” arrangement with UHC to manage the pharmacy benefits portion of the University’s health insurance plan. Experts argue that “carved-in” pharmacy benefit models generally prioritize the interests of health plan administrator (UHC in this case) interests over the interests of the plan sponsor (Fordham); there is a lack of transparency in drug pricing which limits the plan sponsors’ negotiating power thereby benefiting the plan administrator. Based upon recommendations of a Healthcare Advisory Committee consisting of faculty and administrators, the University decided to opt out of this model and change its PBM to Express Scripts Inc (ESI).

Key Information Regarding ESI ID Cards
Dedicated pharmacy benefits ID cards were mailed by ESI on December 14, 2023, to your permanent address listed in the University's system of record. If you have not received your ESI card, you have the option to generate an ID card online using your ESI account. This brief instructional video outlines the process for creating an account and printing your ID card. 

Additionally, you may contact ESI directly at 1-800-939-3721 to request a mailed card.

The UHC ID card will work only for medical benefits and will not work for pharmacy benefits effective January 2024. You must use your ESI card for pharmacy benefits.

Frequently Asked Questions

We encourage you to read the information contained in the below FAQs to familiarize yourself with this transition. 

  • The transition to ESI will mean few or no changes for most members, as the prescription medications that are covered and the terms of coverage will remain the same for most medications.

    • You will continue to have access to the national large-chains and most of the local independent pharmacies.
    • There will be some changes to the list of covered prescription medications. A small percentage of members may be affected by this change: those members and their physicians will have therapeutic alternatives to consider along with the opportunity for clinical appeal to continue their current medications if they so choose. This change to the list of covered medications will be effective July 1, 2024.

  • Yes, we strongly encourage you to set up your account on Express-Scripts.com. The account provides convenient access to view your prescriptions, order refills, track shipments, compare prices, print ID cards, and access your plan information online.

  • Yes, ESI has a mobile app that provides an easy way to access and manage your prescriptions from your mobile device. The app is free. You can download it by searching for Express Scripts in the app store on your device.

  • Yes, your covered dependents can register on Express-Scripts.com and set up their own accounts. On Express-Scripts.com, each family member will only be able to see their own prescription claims on their ESI account.

  • Yes, however, adult dependents must grant permission. To grant or remove permission, each adult must register on the website and follow these steps:

    1. Go to the Account menu.
    2. Select Manage Family Access.
    3. Select or deselect the checkbox next to any adults to whom you want to give or remove permission.
    4. Choose Save Changes.

    Once permission is granted, that person's medications will appear on the other person's dashboard. Adults on your plan can manage medications for children on the plan who are under age 18.

  • Express Scripts (ESI) only issues ID cards in the employee’s name. All covered dependents are on the employee’s account and can use the employee’s card to fill prescriptions. You can print or request additional cards for your dependents.

  • Accredo, ESI’s specialty pharmacy services, will assist you with your specialty medication needs. Through Accredo, you’ll have 24/7 access to specialty-trained pharmacists and nurses who understand your condition. You can contact Accredo at 800-803-2523 to get started or if you have any questions.

  • Yes and you will be able to see all of your active prescriptions in your account on Express-Scripts.com. For instructions on how to continue your mail order prescriptions, please access our step-by-step instructions.

  • Yes, you can opt for mail delivery for your long-term medicine:

    1. Go to the Prescriptions menu.
    2. Select Pharmacy Options.
    3. The screen lists any long-term medicine you can have delivered in up to 3-month supplies. 
    4. If you want ESI to deliver your medicine:
      • Select the checkbox next to the price for a 3-month supply.
      • Click Continue at the bottom of the screen. You'll go to the My Cart screen, where you can complete your order and check out.

  • Yes, you add another address for shipping. Log into your ESI account, then Go to “Account”--> Address and then update or add address for shipping.

  • No, ESI and UHC are two different plans.  Each will provide a Explanation of Benefits (EOB) for processed claims that can be used for reimbursement from your WEX accounts (HRA, FSA, HSA).

  • You can look up the prescription on Express-Scripts.com or on the Express Scripts mobile app. Click on the “Prescriptions” tab and “Price a Medication” or the “Help” tab and “FAQs” to enter the medication and obtain the co-pays at your local pharmacy or home delivery pharmacy.

  • For questions relating to prescriptions, cost, pharmacy access, or home delivery, please call ESI customer service at 1-800-939-3721.

    For questions relating to specialty medications, please call Accredo, ESI’s specialty pharmacy services, at  1-800-803-2523.

    For other questions relating to the University’s pharmacy plan, please contact the Office of Human Resources Management at [email protected] or call 718-817-4930.