Prescription (Illinois)

Why does HSHS require mandatory mail order for prescription maintenance meds?
The HSHS Healthy Plan provides insurance coverage to over 23,000 covered members (colleagues and their families).  In order to continue to provide this benefit, it’s imperative that HSHS control health care costs for its colleagues. Because HSHS is self-insured, the amount of money the System and colleagues pay toward our medical and pharmacy insurance must cover our claims costs.  Prescription drug claims are a significant portion of health care costs and are projected to continue to rise.

HSHS examined many factors prior to its decision in 2011 to mandate mail service for maintenance medication.  After exploring different options, it was determined that mail service was a cost-effective solution to controlling costs because it eliminates dispensing fees and the drug price is generally lower due to the bulk purchases. Mail service also offers the convenience of a 90-day supply of medication and home delivery at no cost to the member.

Mail service for maintenance prescription drugs has proven to be an effective cost control for the HSHS Healthy Plan and has played a significant part in the System by being able to keep the amount colleagues contribute to their health insurance below the national average.
What is the advantage of using mail service for prescription maintenance drugs?
There are three advantages:
  • You are very likely to save money on your prescriptions. While the plan options pay the same percentage of the cost, the overall cost is generally lower with mail order because the mail service program can purchase medications in very large quantities. And, there is no dispensing fee included in the cost of mail service prescriptions, while a dispensing fee is included in each 30-day retail prescription.
  • You have the convenience of home delivery. Medications are delivered directly to your home or another address you specify within 5 days after your order is received, with no charge for standard delivery.
  • Maintenance medications will not be covered after the third fill at a retail pharmacy. They are covered when filled through the Plan’s mail service pharmacy or an HSHS pharmacy (if there is one located in your area).
What if I don't use mail service for my maintenance medications?
  • You may fill your maintenance prescription two times at a retail pharmacy.
  • After a maintenance prescription is filled twice at a retail pharmacy, you must use mail service for subsequent refills to be covered by the HSHS Healthy Plan's prescription drug coverage.
How do I register with the Express Scripts website?
  • Beginning 1/1/2017, visit to register.
  • You will be asked to provide your Express Scripts ID number and email address.   
What is a preferred drug list or formulary? How can I find out if my medication is on this list?

A preferred drug list or formulary is a list of approved drugs for which the HSHS Healthy Plan provides preferred benefits. The preferred drug list is compiled by an independent group of doctors and pharmacists selected by Express Scripts and includes both conventional and specialty medications. Express Scripts reviews nearly 300 drug classes each year to approve medications that are both clinically appropriate and less costly for the HSHS Healthy Plan and its members.

When you receive up to a 30-day supply of medication that is not on the Express Scripts preferred drug list from a retail pharmacy, you will pay an additional $15 copay, or an additional $45 copay for up to a 90-day supply under the mail service option.

To find out if your medication is on the list, you can call 1-800-698-3757 or use the Formulary look up feature on