Here are some frequently asked questions concerning the prescription drug program.

What's on the formulary / what formulary does CGI use?
CGI uses Express Scripts’ (ESI) National Preferred formulary, which was developed by a National Pharmacy and Therapeutics Committee of pharmacists and physicians.  This Committee is an organized panel of 19 non-employee physicians and is supported by four ESI registered pharmacists.  Clinical appropriateness of a drug, not cost, is the foremost consideration. The formulary list may change periodically to reflect new findings. 

A PDF copy of the 2007 Express Scripts National Preferred formulary can be downloaded, listed by either alpha or therapeutic class.

What pharmacies are in the network?
Express Scripts' network of over 56,000 pharmacies includes all national chains.  Click here to locate a pharmacy near you. This information is updated quarterly.

Is my patient able to get their specialty injectable filled at the pharmacy?
Depending on their insurance plan, most patients are able to get their self-injectable medications such as Enbrel, Avonex, Copaxone and Procrit through their local pharmacy.  Prior authorization is not required at this time.  Patients should call customer service at 1-800-545-8905 to verify if they can get these medications through their local pharmacy.

Is prior authorization required for certain medications?
The following medications need prior approval by CGI before prescriptions can be dispensed:

• Medications prescribed in quantities which exceed the maximum recommended dosage. Maximum quantity limits are based on federal and manufacturer guidelines,
• Retin-A prescribed for a patient over 25 years of age.

A letter of medical necessity can be sent to us for consideration. Please mail to:
        Continental General Insurance Company
        Attn:  Medical Management
        PO Box 2650 
        Omaha NE  68103-2650

Getting your patient started using Express Scripts Mail-Order program 
Patients can send in their written prescriptions to ESI through the mail or you as the physician can fax the prescription directly to ESI. Depending on the patient's plan, they may receive a 60 or 90-day supply through mail-order.

New prescriptions should be faxed to ESI at 1-800-636-9493 and must include the following information:

• Patient ID (refer to Express Scripts ID card)
• Patient name
• Patient date of birth
• Prescription information, to include drug name, quantity, refills, instructions and any DAW specifications
• Prescriber’s signature
• Prescriber’s DEA number
• Prescriber’s office phone number

Please note, the fax must be sent from the physician’s office.  

To contact ESI directly, call 1-800-287-4526 or log on to their website at www.express-scripts.com