CoverRx
CoverRx is a Tennessee pharmacy assistance program supported by Express Scripts. It is designed to assist those who have no prescription drug coverage but have a critical need for medication. CoverRx is not health insurance.
Who Is Eligible?
To qualify, an applicant must meet the following criteria:
- Tennessee resident (at least the last six months)
- Age 19 to 64
- Household income below 250% Federal Poverty Level (FPL), see Income Guidelines below
- US citizen or qualified alien
- Cannot have other prescription drug coverage (including Medicare, TennCare, or employer sponsored drug coverage)
| Income Guidelines | |
| Persons in Household | Annual Household Income |
| 1 | $26,000 |
| 2 | $35,000 |
| 3 | $44,000 |
| 4 | $53,000 |
| 5 | $62,000 |
| 6 | $71,000 |
| 7 | $80,000 |
| 8 | $89,000 |
What Benefits Are Offered?
CoverRx participants enjoy:
- Affordable access to approximately 250 medications, mostly generic, on a Covered Drug List (PDF file)
- Includes insulin, diabetic supplies and mental-health drugs
- Discounts on drugs not on the Covered Drug List; no prior authorization for drugs on the Covered Drug List
- Up to five prescriptions per month (insulin and diabetic supplies will not count against the monthly limit)
- Drugs not on the covered list or beyond the limit are available for full payment of the discounted price (price varies by drug)
What Is the Cost to Participate?
Participants pay no monthly premiums to participate in CoverRx, but copayments are required for prescriptions.
| Your Copayments | |||
| Drug Category | Below FPL | FPL to 149% FPL | 150% to 250% FPL |
| Generics: 30 day supply | $3 | $5 | $8 |
| Generics: 90 day supply* | $3 | $10 | $16 |
| Brands/Insulin/Diabetic Supplies: 30 day supply or up to covered limit |
$5 | $8 | $12 |
| Drugs not on the CoverRx list and all prescriptions above the five prescription-per-month limit | Lesser of Discount, MAC or U&C** | ||
| A 90-day supply is not available for covered brand drugs, covered insulin or covered diabetic supplies. *90-day supplies available only through mail order and select retail pharmacies that have chosen to participate. **Discount means a price reduction offered to participants for certain prescriptions. **MAC means the maximum allowable cost of a drug and is a drug reimbursement policy. **U&C means usual and customary charges, which are amounts charged by healthcare providers. |
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When you enroll in the CoverRx program, we will send you a welcome packet with detailed information about how to use the program. Some key points to keep in mind:
- You must pay the full amount for all prescriptions above the monthly five-prescription limit. However, pharmacy discounts are available to help you with the cost of these medications.
- You can fill your prescriptions at participating local retail pharmacies and mail order pharmacies.
In April 2007, CoverRx re-opened enrollment after temporarily suspending applications in February 2007. Applications on the CoverRx waiting list will be processed in order of receipt and before new applications.
- English CoverRx Application (PDF file)
- Spanish CoverRx Application (PDF file)
Please refer to our list of other resources to determine if there are other ways you may be able to obtain your needed medications.
For questions about benefits or enrollment, contact Express Scripts toll-free at 888.560.2649.
PDF files require Adobe Acrobat Reader.