Benefit Summary

Home / Benefit Plan / Pharmacy 2027
← My Benefits Guide

Pharmacy 2027

Cigna

JPS Health Network prescription drug coverage administered by Cigna, offering tiered co-pay and coinsurance costs across multiple pharmacy networks including JPS Pharmacies, JPS Main Campus/MHSW, and CVS/Walgreens/local grocery stores, with different cost structures for the HD500/HD250 plans versus the EPO plan.

How to Use the JPS Health Network Prescription Plan

1. Select any of the options listed and present your Cigna ID card to the pharmacy.
2. Pay the required co-pay or coinsurance amount and sign for your prescription.

Maintenance medications will be filled as a 90-day supply and mailed (free standard shipping) to the home address on file.

2027 Prescription Drug Costs — HD500 or HD250 Plan

Drug Tier Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider)
30-Day Supply 90-Day Supply 30-Day Supply 90-Day Home 30-Day Supply
HD500 or HD250 Plan
Tier 1: Generics
HD prescription drug costs go toward your overall medical plan deductible and maximum out-of-pocket
$15 co-pay after deductible $30 co-pay after deductible $22 co-pay after deductible $56 co-pay after deductible $45 co-pay after deductible
Tier 2: Preferred Brands
HD prescription drug costs go toward your overall medical plan deductible and maximum out-of-pocket
$37 co-pay after deductible $75 co-pay after deductible $60 co-pay after deductible $150 co-pay after deductible $112 co-pay after deductible
Tier 3: Non-Preferred Brands
HD prescription drug costs go toward your overall medical plan deductible and maximum out-of-pocket
$60 co-pay after deductible $120 co-pay after deductible $97 co-pay after deductible $251 co-pay after deductible $225 co-pay after deductible
Tier 4: Specialty
HD prescription drug costs go toward your overall medical plan deductible and maximum out-of-pocket; specialty drugs limited to 30-day supply
20% after deductible (minimum $50; maximum $150) N/A 20% after deductible (minimum $50; maximum $150) N/A 20% after deductible (minimum $150; maximum $450)
HD500 or HD250 Plan

Tier 1: Generics

HD prescription drug costs go toward your overall medical plan deductible and maximum out-of-pocket

Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider)
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 30-Day Supply
$15 co-pay after deductible
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 90-Day Supply
$30 co-pay after deductible
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider)
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 30-Day Supply
$22 co-pay after deductible
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 90-Day Home
$56 co-pay after deductible
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider)
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider) — 30-Day Supply
$45 co-pay after deductible

Tier 2: Preferred Brands

HD prescription drug costs go toward your overall medical plan deductible and maximum out-of-pocket

Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider)
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 30-Day Supply
$37 co-pay after deductible
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 90-Day Supply
$75 co-pay after deductible
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider)
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 30-Day Supply
$60 co-pay after deductible
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 90-Day Home
$150 co-pay after deductible
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider)
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider) — 30-Day Supply
$112 co-pay after deductible

Tier 3: Non-Preferred Brands

HD prescription drug costs go toward your overall medical plan deductible and maximum out-of-pocket

Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider)
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 30-Day Supply
$60 co-pay after deductible
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 90-Day Supply
$120 co-pay after deductible
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider)
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 30-Day Supply
$97 co-pay after deductible
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 90-Day Home
$251 co-pay after deductible
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider)
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider) — 30-Day Supply
$225 co-pay after deductible

Tier 4: Specialty

HD prescription drug costs go toward your overall medical plan deductible and maximum out-of-pocket; specialty drugs limited to 30-day supply

Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider)
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 30-Day Supply
20% after deductible (minimum $50; maximum $150)
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 90-Day Supply
N/A
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider)
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 30-Day Supply
20% after deductible (minimum $50; maximum $150)
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 90-Day Home
N/A
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider)
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider) — 30-Day Supply
20% after deductible (minimum $150; maximum $450)

2027 Prescription Drug Costs — EPO Plan

Drug Tier Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider)
30-Day Supply 90-Day Supply 30-Day Supply 90-Day Home 30-Day Supply
EPO Plan
Tier 1: Generics
EPO plan has an additional maximum out-of-pocket for prescription drugs of $1,600 per individual up to $3,200 for family
$15 co-pay $30 co-pay $22 co-pay $56 co-pay $45 co-pay
Tier 2: Preferred Brands
EPO plan has an additional maximum out-of-pocket for prescription drugs of $1,600 per individual up to $3,200 for family
$45 co-pay $90 co-pay $60 co-pay $150 co-pay $112 co-pay
Tier 3: Non-Preferred Brands
EPO plan has an additional maximum out-of-pocket for prescription drugs of $1,600 per individual up to $3,200 for family
$75 co-pay $150 co-pay $97 co-pay $251 co-pay $225 co-pay
Tier 4: Specialty
EPO plan has an additional maximum out-of-pocket for prescription drugs of $1,600 per individual up to $3,200 for family; specialty drugs limited to 30-day supply
20% of cost (minimum $50; maximum $150) N/A 20% of cost (minimum $50; maximum $150) N/A 20% of cost (minimum $150; maximum $450)
EPO Plan

Tier 1: Generics

EPO plan has an additional maximum out-of-pocket for prescription drugs of $1,600 per individual up to $3,200 for family

Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider)
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 30-Day Supply
$15 co-pay
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 90-Day Supply
$30 co-pay
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider)
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 30-Day Supply
$22 co-pay
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 90-Day Home
$56 co-pay
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider)
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider) — 30-Day Supply
$45 co-pay

Tier 2: Preferred Brands

EPO plan has an additional maximum out-of-pocket for prescription drugs of $1,600 per individual up to $3,200 for family

Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider)
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 30-Day Supply
$45 co-pay
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 90-Day Supply
$90 co-pay
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider)
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 30-Day Supply
$60 co-pay
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 90-Day Home
$150 co-pay
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider)
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider) — 30-Day Supply
$112 co-pay

Tier 3: Non-Preferred Brands

EPO plan has an additional maximum out-of-pocket for prescription drugs of $1,600 per individual up to $3,200 for family

Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider)
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 30-Day Supply
$75 co-pay
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 90-Day Supply
$150 co-pay
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider)
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 30-Day Supply
$97 co-pay
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 90-Day Home
$251 co-pay
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider)
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider) — 30-Day Supply
$225 co-pay

Tier 4: Specialty

EPO plan has an additional maximum out-of-pocket for prescription drugs of $1,600 per individual up to $3,200 for family; specialty drugs limited to 30-day supply

Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider)
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 30-Day Supply
20% of cost (minimum $50; maximum $150)
Any JPS Pharmacy, Home Delivery, or JPS Specialty Pharmacy (Written by a JPS provider) — 90-Day Supply
N/A
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider)
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 30-Day Supply
20% of cost (minimum $50; maximum $150)
JPS Main Campus Pharmacy, JPS MHSW Pharmacy, or Home Delivery (Written by a non-JPS provider) — 90-Day Home
N/A
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider)
CVS, Walgreens, Local Grocery Store Pharmacy, or Cigna Accredo Specialty Pharmacy (Written by either a JPS or non-JPS provider) — 30-Day Supply
20% of cost (minimum $150; maximum $450)
Formulary

The Cigna Healthcare National Preferred Formulary will be used with your drug program. The formulary is a list of medications used as a guide for physicians when prescribing. The formulary also lists medications by tiers, which determines your associated costs.

The formulary is reviewed and updated regularly. For the most up-to-date formulary and FAQs, please visit: jps.benevibe.co

Brand/Generic Co-pay Differential

If a physician or patient requests a brand-name drug when a generic equivalent exists, the brand co-pay plus the cost differential between the brand and generic medication will apply.

Refills

Home Delivery for all 90-day written prescriptions must be filled through JPS pharmacies or Express Scripts Pharmacy. In order to get started with the JPS pharmacy or Express Scripts Pharmacy, ask your doctor for a new prescription written for a 90-day supply with refills up to one year.

To use JPS pharmacy home delivery your options are:
- Go online at jpsmychart.org.
- Call JPS Main Pharmacy toll-free 1-817-702-3531 to begin setting up your home delivery account.

To use Express Scripts Pharmacy:
- Log in to the myCigna App or myCigna.com to move your prescription electronically. Click Prescription and select My Medications from the dropdown menu. Then simply click the button next to your medication name to move your prescription(s).
- Call your doctor's office. Ask them to send a 90-day prescription (with refills) electronically to Express Scripts Home Delivery.
- Call Express Scripts Pharmacy at 1-800-835-3784. They'll contact your doctor's office to get your prescription. Have your Cigna Healthcare ID card, doctor's contact information and medication name(s) ready when you call.

Specialty Medications

Team members could pay more for specialty prescriptions not filled through JPS. JPS Specialty Pharmacy will make sure you get your medications delivered on time, manage your disease state, obtain co-pay assistance and assist with authorizations. When prescribing a specialty medication, the provider may either submit it electronically (e-scribe), fax the prescription to 1-817-702-4714, or contact the JPS Specialty Pharmacy at 1-817-702-4700.

To receive the discounted rate, prescriptions for specialty medications must be written and/or documented in the JPS medical record system by a JPS provider, as are referrals to a non-JPS provider. The prescriptions may be filled through any JPS pharmacies or Cigna network pharmacies. Specialty drugs are limited to a 30-day supply.

When filling a Specialty medication, you must be a JPS patient who has established care with a provider at a JPS hospital-based clinic to receive the discounted rate.

For questions about the Cigna Specialty Pharmacy, contact Accredo at 1-877-826-7657.

Compound Medications

All compound medications over $100 require prior authorization and must be filled at an approved pharmacy. Compound medications have the same co-pays as prescriptions filled at Cigna participating pharmacies. Please contact Cigna at 1-888-854-7085 for additional information or if you are prescribed a medication that requires compounding.

Cigna covers compound drugs that meet these conditions:
- Must be FDA-approved ingredients
- Must not be bulk ingredients
- Must be covered on plan

340b Federal Drug Discount Program

JPS is eligible to receive drugs through the federal 340b Drug Discount Program, which provides outpatient drugs to eligible healthcare organizations at significantly reduced prices. You must be a JPS patient and seen at a JPS hospital-based clinic to receive the discounted rate.

Prescriptions written by a non-JPS Specialist or any provider at a provider-based JPS clinic (Care Connections, all dental clinics, and MHMR) must be submitted, along with your medical records, to your JPS Primary Care Provider for reconciliation. You must fill your prescription at a JPS Pharmacy to receive the best value 340b pricing.

Main Advantages
  • ✓JPS Pharmacies are in-network and offer the lowest cost tiers
  • ✓CVS, Walgreens, and most local grocery store pharmacies are in-network
  • ✓Cigna participating pharmacies accepted across the network
  • ✓Express Scripts Pharmacy offers 90-day home delivery with free standard shipping, 24/7 pharmacist access, automatic refills/reminders, and flexible payment options (split into three equal payments)
  • ✓JPS offers a $5 prescription program for team members at any JPS pharmacy location — visit jps.benevibe.co and select Documents for details
  • ✓myCigna.com allows you to check covered medications, compare costs, manage prescriptions, and find in-network pharmacies
  • ✓To view a list of JPS Pharmacy locations, visit jpshealthnet.org/sites/default/files/2024-06/JPS-Pharmacy-Locations.pdf
Limitations
  • ⚠Team members filling prescriptions written by outside providers can only fill those at Cigna participating pharmacies (Main Campus, CVS, Walgreens, most local grocery store chains, or home delivery)
  • ⚠Specialty drugs are limited to a 30-day supply
  • ⚠Compound medications over $100 require prior authorization and must be filled at an approved pharmacy
  • ⚠To receive the 340b discounted rate, you must be a JPS patient with established care at a JPS hospital-based clinic
Ideal For
  • 👤Team members who use JPS pharmacies will receive the lowest out-of-pocket costs
  • 👤Members on maintenance medications benefit from 90-day home delivery via JPS or Express Scripts Pharmacy
JPS Specialty Pharmacy Discount Card
  1. 1 Team members on our Cigna medical plans will receive a JPS Specialty Pharmacy discount card along with a letter that explains how you could save money on specialty prescriptions by using the JPS Specialty Pharmacy.
  2. 2 Specialty medications are typically high-cost prescription drugs used to treat complex, chronic, or rare conditions. Medications listed as SP (specialty) are defined in the Cigna Healthcare National Preferred 4-tier Specialty Prescription Drug List.
  3. 3 What you need to know:
    • You’ll pay your plan’s lowest co-pay if you get a prescription or referral from a JPS provider and fill it at JPS Specialty Pharmacy. Call JPS Specialty Pharmacy at 1-817-702-4700 to assist.
    • Your plan only covers up to a 30-day supply of specialty medication at one time.
    • You can fill your specialty medication prescription at JPS Specialty Pharmacy or Cigna’s Accredo® Specialty Pharmacy.
    • Receive your medications via free shipping to your home address on file.
  4. 4 To take advantage of the plan’s lowest co-pay, have your doctor’s office send your prescription to JPS Specialty Pharmacy:
    • E-prescribe it (send it electronically) listed as “JPS Infusion Pharmacy at 1450 8th Ave, Fort Worth”
    • Fax it to 1-817-702-4714
    • Call JPS Specialty Pharmacy at 1-817-702-9355

If you need help or have questions, call the JPS Team Members Health & Wellness Clinic at 1-817-702-9355.

Provider

Cigna

1-888-854-7085

mycigna.com