Filling Your Prescriptions
Express Scripts is the Pharmacy Benefit Manager for the WTC Health Program and offers many ways to fill any WTC-related prescriptions depending on your situation. Express Scripts has a large network of retail pharmacies and home delivery options to provide all members with their WTC-related medication(s).
You can find participating pharmacies near you using the Express Scripts pharmacy locator in the Express Scripts Member Portal online. If you have not set up your Express Scripts account, you can register here .
Please make sure to tell your pharmacy which prescriptions should be billed to the WTC Health Program. The WTC Health Program only covers prescriptions needed to treat your certified WTC-related health conditions and are prescribed by a Program provider.
Some prescriptions may need prior authorizations to be covered by the Program. Your WTC Health Program provider should complete and submit these for you. In some cases, your WTC provider may need to submit a second prior authorization to your primary insurance as well.
Important: For Survivors, a process known as Coordination of Benefits (COB) is required for the WTC Health Program to cover prescriptions at no cost to you. Survivors must make sure that the pharmacy they are using is in network for both your primary health insurance and in the Express Scripts network.
For Survivors, the Express Scripts network includes Optum and CVS/Caremark home delivery pharmacies.
Survivors must follow the steps necessary for this process on the Coordination of Benefits page.
There are unique pharmacy options for both responder and survivor members. Review the table below to select options available to you:
| Pharmacy Options | Responder | Survivor |
|---|---|---|
| Retail |
|
Up to 90-day supply at retail pharmacies in Express Scripts network AND in primary insurance network |
| Home Delivery | 90-day supply through Express Scripts Home Delivery | 90-day supply through home delivery pharmacy in Express Scripts network AND in primary insurance network |
| Specialty | Up to 30-day supply through Accredo Specialty Pharmacy | Up to 30-day supply at any pharmacy in Express Scripts network AND in primary insurance network |
Responders who have specialty medications can get these prescriptions covered and filled through Accredo Specialty Pharmacy. Other pharmacies for specialty medications are not in Express Scripts’s network and cannot be covered by the Program.
Responders with specialty medications can visit the Accredo website or call 1-855-540-1780 with any questions, to fill prescriptions, access plan information, and track online orders.