The State of Delaware Open Enrollment for Medicare eligible retirees and their Medicare eligible dependent(s) is October 10 through October 21, 2016, for the plan year January 1 – December 31, 2017.

The annual open enrollment is your once-a-year opportunity to enroll or make changes in the Highmark Delaware Special Medicfill Medicare Supplement Plan and Express Scripts Medicare (PDP) Prescription Drug Plan. More details are on the way from the Office of Pensions to all Medicare eligible retirees. The plan rates and documents for the 2017 Special Medicfill Plan year are available online.

Watch for additional information about the 2017 prescription drug benefit from Express Scripts being mailed to Medicare eligible retirees' homes in late September. View the FAQs to learn more.

Effective August 1, 2016 your State of Delaware prescription drug plan with Express Scripts has introduced a new process for Medicare Part B eligible prescription drugs and supplies. When you use a retail pharmacy for your Medicare Part B eligible medication or supply needs, you will be asked to present the prescription along with your Medicare ID card and Express Scripts ID card in order to verify your Medicare Part B eligibility.

This new process will allow the State of Delaware to receive reimbursement from Medicare for Medicare Part B eligible medications or supplies that you are obtaining through your Express Scripts drug plan. Until now, the State of Delaware has paid the full cost less your copayment. This new process does not have any impact on the Express Scripts copayment you pay for your medications and supplies.

View the FAQs to learn more.

Express Scripts Contact Information

  • Website
  • Mobile App
  • Express Scripts Medicare Member Services: 1-877-680-4883
  • State of Delaware Office of Pensions: 1-800-722-7300
  • Statewide Benefits Office: 1-800-489-8933

Benefit Descriptions

  • State of Delaware Medicare Prescription Plan: Express Scripts Medicare Prescription Drug Plan (PDP)
  • State of Delaware Medicare Supplement Plan (provided by Highmark Delaware): Group Special Medicfill Health Care Plan
  • Eligibility Criteria For Enrollment In Both Prescription and Supplement Plans
    • If eligible, you may enroll in Special Medicfill and Express Scripts Medicare Prescription Drug Plan (PDP) when:
      • You are retired and turn 65 (enrollment in Medicare is required).
      • You are 65 or older when you retire (enrollment in Medicare is required and must be effective on your retirement date).
  • Covering a Spouse
  • Important Notes
    • Coverage through another Medicare Part D prescription drug plan is not allowed if you wish to keep your prescription coverage through Express Scripts. If you enroll in another Medicare prescription drug plan, prescription drug coverage through the State of Delaware for you will terminate.

      Retirees and/or their dependents must enroll in Medicare A and B when eligible due to age or disability, and a signed copy of the Medicare card must be submitted to the Office of Pensions or to the non-State participating group's benefits office prior to enrollment in the Highmark Delaware Special Medicfill with Prescription Coverage Plan.

      When your enrollment is submitted for Express Scripts Medicare prescription coverage, you will first receive a pre-notification letter from Express Scripts, and you will receive new identification cards in the Welcome Kit a few weeks later.

Rates effective January 1, 2016

Prescription Coverage 30-Day Supply 90-Day Supply
Tier 1
$8.00 $16.00
Tier 2
Preferred (Formulary)
$28.00 $56.00
Tier 3
Non-Preferred (Non-Formulary)
$50.00 $100.00

Cost Savings With 90-Day Prescriptions: You'll pay only 2 times your 30-day retail co-payment if you order up to a 90-day supply of covered medication at a 90-day participating pharmacy or through Express Scripts mail order service.

Retail Pharmacy

You may have your prescriptions filled at any pharmacy that participates in the Express Scripts network. If the pharmacy is also a 90-day participating pharmacy, you may fill maintenance or other prescriptions for up to a 90-day supply. If the pharmacy is not a 90-day participating pharmacy, you can fill prescriptions for up to a 60 day supply.

To verify coverage at a particular pharmacy, check the Express Scripts Website or call Express Scripts Medicare Member Services at 1-877-680-4883.

Home Delivery Via Express Scripts Pharmacy

To have a new prescription filled through the Express Scripts Pharmacy:

  • You may mail the prescription, a completed mail-order form, and payment to Express Scripts Pharmacy, OR ask your doctor to fax the prescription to Express Scripts Pharmacy by calling 1-888-327-9791 for instructions.
    (Only your doctor can fax prescriptions.)
  • Refills may be ordered online at Express Scripts.

For more information, call Express Scripts Medicare Member Services at 1-877-680-4883.

Forms and Documentation

Appeal Process