Enrolling your pharmacy
By taking steps before a disaster strikes to learn about and enroll in EPAP, pharmacies can help patients get the care that they need when every second counts. To get started, contact EPAP by calling Express Script at 855-793-7470
Initiating a claim under EPAP
Once you have enrolled in EPAP, the pharmacy must ensure that all of the following criteria are met before providing assistance:
- Confirm that EPAP has been activated in your patient's area: Claims can only be processed during the time and for patients who are from a location specified in the EPAP activation. To find out whether EPAP has been activated at this time in the patient's area, check the list of current EPAP activations. Please note that the areas are subject to change.
- Confirm patient eligibility: EPAP coverage only extends to uninsured patients. Patients that have health insurance, such as an individual health insurance policy or employer-sponsored coverage, public insurance, such as Medicare, Medicaid, or other third party coverage, are not eligible to receive assistance under EPAP.
- Check for a valid prescription: Eligible individuals must have a new prescription from a licensed health care practitioner, a current prescription bottle, a prescription phoned in by a licensed health care practitioner or proof of an existing prescription in order to receive a prescription fill and/or limited durable medical equipment (e.g. canes, walkers, wheelchairs and diabetic supplies).
- Ensure that the prescription and/or DME is covered under EPAP: EPAP only covers certain prescriptions and DME. To find out whether the patient’s prescription and/or DME is covered, please see the EPAP Formulary and Durable Medical Equipment (DME) List. Enrolled pharmacies must dispense the generic form of medication unless otherwise indicated as Brand Medically Necessary (BMN) or Dispense as Written (DAW) by the licensed health care practitioner.
- Provide no more than a 30 day supply of prescription drugs: Patients will receive an initial 30-day supply of most prescription drugs or specific medical supplies . Prescriptions
may be renewed every 30 days for as long as EPAP is active. If patients
rely on medical supplies, they can get additional supplies every 30 days
for as long as EPAP is active. DME is typically only provided once, but
if it is lost or stolen after it has been issued, it may be replaced.
Vaccines are typically a single course of treatment and do not need to
If you have questions, call EPAP by calling Express Script at 855-793-7470.