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Pile of Pills

MAIL ORDER CHEAT SHEETS

It didn't take me long to realize that, even as a young, tech-savvy nurse who grew up in an independent pharmacy (and, therefore, speak "pharmacy"), working with mail order pharmacies was still going to be a challenge. These "cheat sheets" grew out of the realization that it was, very likely, even harder for my patients. They're regularly updated as I learn new information about each mail order pharmacy. Feel free to share them far and wide! However, keep in mind that there may be other mail order pharmacies available to you based on your insurance and where you live in the US; these are simply the ones that I've gained experience working with.

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Click on each image to be led to that mail order pharmacy's "cheat sheet" (originally created using Google Docs, they are now in the form of a webpage on this site). They include detailed instructions about how to set up an account and begin filling your prescriptions as well as helpful tips for each mail order service that I've learned along the way. Clicking on each mail order pharmacy's name will lead you to their website.

FINDING YOUR MAIL ORDER PHARMACY

Most mail order pharmacies are owned and operated by PBMs—these are the mail order pharmacies I'd avoid using if your insurance allows you to use a non-PBM-owned mail order service, such as those provided by Costco and Sam's Club. That said, a majority of patients' only option will be the mail order (or specialty) pharmacy owned by the PBM contracted with their insurance plan, and your plan may even force you to fill some or all of your prescriptions using this pharmacy* under certain circumstances (if you want them paid for...).

 

The best way to determine which mail order pharmacy/ies you can work with is to contact your insurance company directly via their "member services," "customer support," etc. phone number listed on your insurance card. You may also be able to confirm this information by logging into your online account with them (they usually list information about who provides mail order services for their members—looks for keywords like "mail order," "shipping," or "refill").

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*Forcing patients to use the mail order pharmacy owned by their plan's PBM is an example of what we call patient steering, which is illegal (but still happens all the time through a number of legal loopholes). If this has happened to you, consider filing a complaint with your state's Department of Commerce (or other applicable regulatory body) or the Centers for Medicare and Medicaid (CMS), if you're a Medicare patient. Click here for more information.

Before getting
started...

I strongly recommend contacting your insurance company directly to confirm both (1) what mail order service(s) is/are available to you, if any, and (2) pricing information. Given how convoluted prescription pricing is in the US and the exponential ride of drug costs for patients, I think it makes sense to consider this in your decision of what pharmacy to use (especially if you're voluntarily moving your prescription to help out your local independent pharmacy). If calling, use the "customer support," "member services," etc. number on your insurance or pharmacy benefit card and make sure to ask about Costco or other non-traditional mail order services. When inquiring about pricing, ask specifically about the days' supply and quantity you'd want to fill at X, Y, and Z pharmacies in order to get accurate cost information (remember, you'll be speaking with an operator who probably isn't very knowledgable about pharmacy care and medications, so you'll want to have your medication strength, dose, etc. handy). 

 

Information about how to check pricing information (and possibly confirm your mail order option(s)) on your own is listed below; however, I think there's a benefit to calling in that you can confirm both pricing and mail order options at the same time, and for some people a phone call might be easier than an online tool.

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For patients whose PBM is CVS Caremark (you should have a separate CVS Caremark card or your current pharmacy might be able to help you determine this), you can check pricing information on your own by logging into your online account at caremark.com and clicking on Plan & Benefits → Check Drug Cost & Coverage. If you haven't already made one, check out the CVS Caremark cheat sheet below for instructions.

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For patients whose PBM is Express Scripts (your current pharmacy might be able to help you determine this), you can check pricing information on your own by logging into your online account at express-scripts.com and clicking on Prescriptions → Price a Medication. If you haven't already made one, check out the CVS Caremark cheat sheet below for instructions.

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For patients whose PBM is OptumRx (your current pharmacy might be able to help you determine this), you can check pricing information on your own by logging into your online account at optumrx.com and clicking on Member tools → Drug pricing and information. If you haven't already made one, check out the OptumRx cheat sheet below for instructions.

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For patients with HealthPartners plans, you can check pricing information on your own by logging into your online account at healthpartners.com and clicking on My Plan  Pharmacy  Compare Drug Costs. This will lead you to the MedImpact (HealthPartners' PBM) website and will allow you to compare drug costs at different pharmacies.

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Capsule is a startup pharmacy based out of New York City that specializes in home delivery of patients’ medications. They have physical offices in major cities, where, if you live within their delivery area, your prescription(s) are filled before being hand-delivered to you at a scheduled time.

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While not a traditional "mail order" pharmacy, I've included them here since they've proven to be a viable alternative to filling prescriptions at a local retail pharmacy and are (based on my experience) a good fit for patients who are tech savvy and would prefer local delivery of their prescriptions rather than receiving them via mail.

Image by montatip lilitsanong
Image by ANIRUDH

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An exception to the rule that mail order pharmacies... well, suck, Costco's mail order pharmacy is far better to interact with. They're responsive via email and available 24/7, work fast, and calling them leads you to—novel, I know—actual pharmacy technicians rather than operators who simply answer the phone. For this reason, if your insurance allows you to use their mail order pharmacy, they're the one I'd recommend above all others (you do NOT need to be Costco member in order to fill prescriptions with them). However, given a number of my own patients use them and, personally, I don't think their website is the most user-friendly, I still felt it would be helpful to make a cheat sheet for them.

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Of note, they also offer the filling and pickup of prescriptions at their warehouse locations (also open to non-members), and have a self-pay pricing model called the Costco Membership Prescription Program (CMPP, which does require a Costco membership). In my opinion, both of these help make Costco a great alternative to using a low-quality local chain or traditional mail order pharmacy, if you don't have a high-quality independent (or chain) pharmacy available to you.

Similar to Costco, Sam's Club has their own mail order pharmacy and patients are NOT required to be Sam's Club members. I admittedly have no personal experience working with them or feedback from patients of my own, but given they're not a Pharmacy Benefit Manager (PBM), I'd recommend checking them out before moving your prescription to one of the pharmacies listed below, if your insurance allows.

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The mail order pharmacy owned and operated by Caremark, a PBM and CVS Health subsidiary (which also owns the CVS chain pharmacy network).

Image by Melany @ tuinfosalud.com
Image by Pawel Czerwinski

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The mail order pharmacy owned and operated by Express Scripts, a PBM and Cigna subsidiary.

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HEADS UP! As of July 15th, 2024, I've become aware that Express Scripts has undergone a rebranding to "Evernorth." Apparently, this rebranding actually happened awhile ago in 2020, but I suspect is being implemented now due to their recent entry into the "hot seat" as awareness of PBM abuse grows. However, until this rebranding is ironed out, for the sake of ease all mentions of Express Scripts on this site will remain as such.

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The mail order pharmacy owned and operated by OptumRx, a PBM and subsidiary of UnitedHealthcare (UHC). If you have a UHC plan, this is likely your mail order pharmacy.

Image by Christina Victoria Craft
Image by Wengang Zhai

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The mail order pharmacy owned and operated by WellDyne, a PBM that works with various health insurance companies. In my experience, my WellDyne patients are exclusively HealthPartners members.

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