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Understanding how features of your plan work is important as you PLUG IN to Choose

by on October 7, 2015

In 2016, AEP is offering the choice of three consumer-directed health plans (CDHPs) to pre-65 retirees and employees. In consumer-directed health plans, it is vital to understand how prescriptions are handled, and how health spending accounts can be used to help pay for your medical expenses.


Express Scripts (ESI) will continue to be the vendor for AEP’s prescription drug coverage in 2016. ESI is a large pharmacy benefit manager that negotiates costs for prescriptions with drug manufacturers. ESI also works closely with national chain pharmacies as well as individual pharmacies to make sure AEP members get a discount on prescription medications.

Knowing the costs of your prescriptions will be important to you under a CDHP because none of the new medical plans will provide for a flat-dollar co-pay for drugs.

Instead, you may be responsible for either the full discounted cost of the drug, a percentage of that cost, or no cost, depending on where you stand in terms of the plan’s annual deductible and/or out-of-pocket maximum. Current members may use the Price Your Medication tool provided by ESI’s website today. Current and prospective members should call ESI’s patient care advocates at 1-800-841-3045.


Health spending accounts such as Health Reimbursement Accounts, Health Savings Accounts and Flexible Spending Accounts may be used to pay your medical expenses.

The Health Reimbursement Account (HRA) is set up and funded by AEP. Only AEP can fund this account, and it is only available for participants in the HRA Plan.

The Health Savings Account (HSA) is like a 401(k) retirement account, but it is for medical expenses. You can only have an HSA if you enroll in the HSA Plus or the HSA Basic plans next year.

The Flexible Spending Account (FSA) is funded by you through pre-tax payroll deductions. It is available to participants in all three plans but there are restrictions depending on the plan you choose.


We encourage you to visit the AEP HealthHUB ( for more detailed information on all of your medical plan options and tools available. The AEP HealthHUB is an external site with no password required so that spouses and pre-65 retirees can access; AEP Now access is not required for the site.

The quickest way to receive answers for any specific questions is to contact our subject area experts and vendor partners directly.

Anthem – Medical Plan questions: Phone: 1-877-585-9572; website:

Express Scripts – Prescription Drugs: Phone: 1-800-841-3045; website:

HealthEquity – HSA questions: Phone: 1-877-713-7712; website:

From → Benefits

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