Express Scripts Home Delivery

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.

Getting started

To begin filling prescriptions through Express Scripts, head to express-scripts.com and create an account (or sign into the one you already have), then follow the steps listed below.

Express Scripts also owns a specialty pharmacy, Accredo, that only fills "specialty" medications (for more info about how specialty pharmacies differ from traditional mail order pharmacies, click here). I don't yet have personal experience working with Accredo, but it appears to involve a lot more care coordination and direct communication with their team over the phone than when working with Express Scripts. To visit Accredo's website, click here.

01

Click on Register in the top right hand corner, then enter your personal and health plan information to create an account, or select Log in if you already have an account (you may if you've used it previously to access your prescription claims information).

If you encounter an error message while trying to create an account, give Express Scripts a call at one of the numbers listed below. If their automated answering machine asks why you’re calling, continue stating that you’d like to “speak with an advocate” until you’re connected to an operator or asked to confirm your personal information. Usually, I'm connected with an operator almost immediately.
- Plans where Prime Therapeutics is the PBM → (833) 715-0970 (select option “0”)
  - If you're not sure if this is you, your current pharmacy might be able to help you determine which PBM your plan uses (in my experience, this has always been the case for patients whose RxBIN number on their insurance card is 610455, but there are certainly other applicable RxBIN's, since Prime Therapeutics serves a wide variety of insurance plans). If they can't, call your insurance company directly to confirm.
  - I've found that, for many individuals with these plans (in my experience, always with Blue Cross Blue Shield patients), Express Scripts has multiple accounts in their system for different coverage years (such as 2023 and 2024) and a different member ID associated with each account, which may or may not be the one listed on your current health insurance card (this can even happen when you’re technically still on the same insurance plan from year to year). Confusing, I know! Calling to confirm you’re using the correct member ID they have connected to you in their system when setting up your account usually fixes the issue. Further guidance can be found in the bulleted Tips section further down this page.
- All other commercial plans → (800) 282-2881
- Medicare plans → (866) 529-4917
- TRICARE members → (877) 363-1303
- TTY numbers can be found here

Sometimes, patients unknowingly have an Express Scripts account that was made for them automatically when they signed up with their insurance plan. If your personal details help locate an account that you don't recognize or can't login to (e.g., if the email address associated with the account is no longer accessible to you), call Express Scripts directly using one of the numbers above to get assistance with logging in.

02

Once logged in, click on Account in the bright blue navigation bar to update the settings listed below.

Payment Methods: Here you’ll enter details for the card(s) you’d like to use to pay for your medication(s). As with any online ordering system, I recommend using a credit card in case there is ever a fraudulent transaction (versus a debit card, which doesn’t offer the same fraud protections).

You MUST add a shipping address to your account before inputting card information.

If you don’t have a debit or credit card, Express Scripts allows patients to receive invoices by mail for orders costing less than $150. For orders that cost more than $150, a credit or debit card is required for payment.

Addresses: Here you’ll enter the address(es) where you’d like your prescriptions to be shipped.

Communication Preferences: Here you can set your email and phone number(s) to receive email, phone, and/or text notifications about your account, as well as select how’d you’d like to receive documents.

If there is a setting available called "Data Privacy and Permissions,” I recommend that you set this to “Ask me to confirm new prescriptions submitted by me or my doctor." Since medications filled by mail order pharmacies are non-returnable and non-refundable, you want to make sure they're not going to automatically fill prescriptions that are accidentally or incorrectly sent to Express Scripts by your provider(s) or that you don't need, and this is the best way to do that. However, this means that, once you've asked your provider to send a prescription to Express Scripts (or submitted an order in your account for a prescription that required renewal), you'll want to keep any eye out for notification that they've received the prescription, as you'll need to give them permission before they can fill and ship it to you.

Based on my experience thus far, Express Scripts sends the following types of notifications via email, if you have email notifications turned on (as someone who doesn't have experience using them, I can't speak to the nature of their text notifications).

New prescription ready for refill | YES (if you selected the "Data Privacy and Permissions" setting I recommended above; otherwise, you will get a notification that an order is already processing for you)

Refill reminders | YES

Prescription out of refills or expiring soon | YES

Order placed | YES

Refill too soon | YES

Pharmacy hasn't heard back from your provider (e.g., about a new prescription or information they need before filling your prescription) | YES

Order processing | YES

Order shipped | YES

Shipment out for delivery | NO

Shipment delivered | YES

Secure message (that you sent them) received | N/A (while it appears patients can receive secure messages via their Express Scripts account, I have yet to have a patient do so, and this is not currently a tool that you can use to reach out to them)

Response to secure message available | N/A

Prior Authorization (PA) decisions | NO

Payment method expiring soon | UNSURE

Caregiver: Here you can input the name, date of birth, and contact information for a person in your life who you’re ok with contacting Express Scripts on your behalf.

Some plans don't offer this feature (a real bummer, in my opinion). If that is the case and you’d like someone in your life to be able to contact Express Scripts on your behalf, you’ll need to call them and ask how to complete Release of Information documentation (I've admittedly never done it this way myself. Because I'm always able to verify patients' details and prove that I'm a Registered Nurse, they usually let me get away with speaking to them about patients for whom this setting doesn't exist the few times they haven't, I've hung up and called them back to speak with a different operator, or have found another way to troubleshoot the situation).

03

Now that your mail order account is set up, contact your healthcare provider(s) to request that they send a new prescription order directly to the Express Scripts mail order pharmacy.

If you take multiple medications that are prescribed by more than one provider, you’ll need to reach out to each of them separately. If they ask why your prescription(s) can’t be transferred from your current pharmacy, inform them that traditional mail order services aren't willing to contact other pharmacies for prescription transfers (many clinics are not aware of this). If they ask, you can provide them with the following prescribing information:

ePrescribe: Express Scripts Home Delivery
“Easy Rx” number for calling in, faxing in, or sending e-scripts: (888) 327-9791
Address: 4600 North Hanley Rd, St. Louis, MO 63134
NCPDP ID: 2623735
- Many clinics aren't aware of what this number is (a type of provider ID specific to pharmacies), yet most mail order services list it in their contact information. If the clinic doesn't ask for it, I don't offer it, unless they're having trouble locating the pharmacy in their ePrescribe software.

I recommend that you request they send a 90-day / 3-month supply prescription, unless there is a reason that you’d like a lower quantity filled each time you order. Filling 3 months’ worth is appropriate for many medications and usually more convenient (of note, many independent pharmacies will only fill monthly supplies of expensive brand name medications because they lose even more money when filling larger quantities of these kinds of drugs). Additionally, it's often the most cost-effective option when filling with a mail order pharmacy (sometimes, they will even offer patients a free copay, giving you 3 months of medication for the price of 2 months’ worth).

Certain medications used on a weekly basis, such as injectables like Ozempic and Praluent, are often prescribed in a days’ supply that is divisible by 7 (e.g., an 84-day supply instead of a 90-day supply for 3 months of medication).

If your provider sends a prescription for the wrong days' supply (e.g., 30 days instead of 90 days), you'll likely need to have them re-send a corrected prescription. Unfortunately, traditional mail order pharmacies aren't usually willing to adjust the days' supply from how the prescription is written, even if it's possible and medically appropriate.

04

Once your provider sends a new prescription and that prescription has been received by Express Scripts, the mail order pharmacy will begin processing your refill (or first fill, if this is a new medication for you) immediately without asking for your consent (unless you've selected the "Data Privacy and Permissions" setting I recommended above). For this reason, it's best to be on the lookout for notifications from them or login to your account daily so that you can ensure they end up processing an order for the correct medication, dose, and days' supply (and provide consent for them to begin filling the prescription, if needed).

If you selected the "Data Privacy and Permissions" setting I recommended above, new prescriptions that are eligible for refill will be denoted by a purple "NEW" banner and "New prescription" lettering beneath the prescription information (e.g., Rx#). You can now add that prescription to your cart and complete your order, at which point Express Scripts will begin filling it for you.

New prescriptions might not display information like the prescriber, number of refills, quantity, and days' supply of a prescription right away. If this is the case, to ensure your provider sent a prescription for the correct dose and days' supply, I recommend confirming this information by calling Express Scripts directly.

If it's too soon to refill your medication, Express Scripts will let you know the earliest date when it can be billed to your insurance plan. In my experience, this has always been communicated via email, if you have these notifications turned on (admittedly, I've never received text notifications from Express Scripts on behalf of my patients, so they may communicate this via that method as well).

Your active prescription(s) will be listed under My Medications on the homepage (or under Prescriptions → My Medications). If a medication is in this list but displays “Eligible for Delivery” or "Switch to Express Scripts Pharmacy..." beneath the prescription information (e.g., Rx#) OR a price/X-month supply on the right hand side, there is no active prescription for that medication; rather, this is simply a placeholder for a medication you’ve billed to insurance within a prescribed period of time, and is a marketing strategy for encouraging you to move additional prescriptions to mail order.
- Technically, you can add any medication under My Medications to your cart and submit an order in this state, which will prompt Express Scripts to reach out to your provider(s) on your behalf, but I’ve found that it’s better to contact your provider(s) personally and make the request yourself; they make take longer to respond to a request from Express Scripts than one from you (especially if they've never sent prescriptions to them for you before), and sometimes clinics will not send an order to a new pharmacy without getting the patient’s verbal consent first (something, I've found, that doesn’t always get communicated to the patient, causing further delay).

Refills

For future refills, you’ll place your order by finding the medication(s) you want to refill under My Medications (or Prescriptions → My Medications), adding those medication(s) to your cart, and then clicking on the blue shopping cart button in the upper right hand corner.

Moving forward, I recommend submitting refill requests 2 weeks before you're going to run out of medication (3 weeks if your prescription is out of refills or expired). This will give Express Scripts plenty of time to bill your insurance and resolve any issues before shipping your medication to you. Don’t worry about submitting a refill request too early—if it’s too soon to fill per your insurance, Express Scripts will notify you and set your order to begin processing as soon as your insurance allows.

If your medication has a Prior Authorization (PA), it's helpful to note the PA's expiration date, since the PA expiring can also serve as a time-consuming hoop to jump through prior to the pharmacy being able to refill your medication. If you don't know the expiration date, you can confirm this by sending a secure message in your account or by calling your insurance plan directly using the number listed on your insurance or pharmacy benefit card.
- As mentioned above, Express Scripts does NOT notify patients via email about PA decisions, and also provides mail order services in some situations when they are NOT a health plan's PBM (and, therefore, don't handle your PA decisions). So, if you're a patient in this situation (in my own experience, with Blue Cross Blue Shield plans whose PBM is Prime Therapeutics) and you know this process is ongoing (i.e., Express Scripts is waiting for a PA to be approved before they can fill your prescription) and there appears to be a delay, make sure that (1) Express Scripts sent a PA request to your clinic, (2) that your clinic followed up on it, and (3) that your insurance company is still working on their decision. Additionally, the only way for Express Scripts to know if the PA has been approved or denied (if they're not your plan's PBM, as is the case with my Blue Cross Blue Shield patients) is to try running a claim and see if it goes through; for this reason, if you're notified by your insurance company (usually via letter) or clinic that a PA was approved, give Express Scripts a call to let them know so that they can continue filling your prescription. Of note, this process is simpler for those whom Express Scripts is both their mail order pharmacy AND the PBM for their plan, since they're the ones making PA decisions.

When you need a refill of a prescription that is now out of refills, you may not be able to add the prescription to your cart and check out like usual (it seems to depend on the plan); in that case, I'd recommend contacting your clinic directly to ask that they send a new prescription because the old one was out of refills (retail pharmacies would usually do this themselves, so if the clinic's confused you can explain that it's just easier this way for Express Scripts specifically). You can also call Express Scripts directly to request that they refill it, which will prompt them to reach out to your clinic for a new prescription, but I usually opt to call a patient's clinic directly (partly because it's almost always easier to reach/communicate with a clinic, despite this sometimes being difficult these days, and partly because clinics commonly don't follow up on new prescription requests from pharmacies).

I DO NOT recommend placing any prescription on autofill (i.e., it being filled regularly and automatically without your consent). Once medications are shipped to a patient from a mail order pharmacy, they are non-returnable and non-refundable, with few exceptions (the only situation I've encountered where a return was accepted was when the mail order pharmacy made a mistake). To avoid receiving medication that you don’t need, use tools like calendar reminders to keep track of when it’s time to order your next refill. Yes, it's tedious, but it will save you from receiving medication you don't need and/or can't afford.
- Per Medicare law, patients with Medicare insurance are not allowed to autofill medications, as it can lead to a wasteful accumulation of medication that patients don't need, but Medicare still paid for. In my experience, most mail order pharmacies still display this as an option in Medicare patients' accounts, and this is true for Express Scripts; to confirm whether this setting is actually usable, you'll have to reach out to them directly (since I don't autofill my patients' medications, I'm unfamiliar with what happens when you try to turn this setting on for a Medicare patient).

Tips for working with Express Scripts

Logging into Express Scripts always requires two-step verification, either via email or text.

Occasionally, the Express Scripts website will tell patients that their username and password they’ve set as their login credentials are incorrect, even when they’re correct (especially if these credentials have been saved in your browser using autofill). If this happens to you, close and reopen the Express Scripts website and make sure to type your credentials in manually (even if you usually have them saved) when trying to login again. Doing this usually avoids having to reset your password.

As mentioned above, for all patients covered by plans where the PBM is actually Prime Therapeutics instead of Express Scripts (especially those on Medicare), it’s possible that you technically have two (or more) Express Scripts accounts: one(s) associated with a previous year’s/previous years’ coverage (if you were on the same plan) and one associated with the current year’s coverage. This can cause complications with registering for an online account and/or when logging in after registering. I have (unfortunately) extensive experience addressing this issue, so feel free to reach out to me here if you're unable to fix it on your own or have any questions.
- If you encounter issues with registering for an online account, call Express Scripts directly at (833) 715-0970 and press “0” to speak to an operator. Sometimes, Express Scripts has to initiate the “activation” of the correct account or provide you with an alternate member ID number, so if the operator isn't sure what to do (which has almost always been the case for me), suggest that they try this. If they have incorrect insurance information or claim that they’re not your mail order pharmacy provider (but you know that, indeed, they are), request that they contact Prime Therapeutics directly to verify your coverage (they can do this while you remain on hold with them).
- If you encounter issues logging into your account in the future (e.g., seeing a notice on the homepage that “Your Benefit Plan Has Ended” or not seeing medications that were previously present), click on Benefits in the bright blue navigation bar → Additional Benefits and make sure your current prescription drug plan is selected. If the wrong plan is selected, click on the correct plan and then select Save.

Since Express Scripts doesn't offer secure messaging and their website's interface has a number of limitations, calling them is my go-to way to get a hold of them and handle problem solving. Personally, I've found that I usually reach an operator almost immediately.

It's not uncommon that Express Scripts will require your verbal consent before filling a medication for you for the first time. If you receive a call from them, sometimes this is why. However, if asked by an operator if you want to remove this requirement for consent from your profile, explain to them that you don’t want them filling things automatically for you, if that's an available setting in your account. In my opinion, having to field a phone call from them for new prescriptions is better than being sent and paying for medication that you don’t need or can't afford.

If you cancel an order because you don’t need that medication refilled yet (this can happen when your provider first sends a new prescription order to Express Scripts, if Express Scripts begins processing a refill right away), you’ll need to call Express Scripts directly when it’s actually time to order your refill so that they can “reactivate” the prescription (until then, it will display as "canceled" under My Medications and you’ll be unable to add it to your cart).

If you ever get a notification that your order’s been “canceled” or “can’t be fulfilled,” always login to your account to see for yourself what’s going on. In short, I've received a wide variety of different kinds of email notifications from Express Scripts on behalf of patients that have simply been inaccurate (and after hundreds of phone calls with them, I have yet to figure out why this happens or how to prevent it). The status of any current orders can be found by clicking on Active Orders on the homepage (or under Prescriptions → Order History). If you need further assistance, call Express Scripts directly.

Similar to above, if you ever get a notification saying that your medication requires a PA and that you must contact your care provider to begin this process, call Express Scripts directly to confirm whether that is indeed the case or not, as sometimes this notification is sent in error (see above). Also, know that, despite what that email says, Express Scripts will always automatically contact your provider themselves when a PA is required; you will only need to reach out to your provider yourself if you get further notification from Express Scripts that your provider is not responding to their communications (though, admittedly, this is common).

Express Scripts offers several speeds at which your prescriptions to be delivered. Standard shipping is free (including for medications with specific shipping guidelines set by the manufacturer, such as refrigerated items that must be shipped next-day), but shipping may be expedited on any prescription order, per your request. However, keep in mind that shipments only move on the “business days” of Monday through Friday (sometimes Saturday) and upgrading your delivery method does NOT speed up the processing of your prescription orders while they're still moving through the Express Scripts mail order facility.

Express Scripts has a smartphone app available for free for both iOS and android devices. However, I find their website easier to use unless you're simply submitting a refill request.

Express Scripts mail order pharmacy won't fill partial boxes of a medication that comes packaged this way (common examples are injectable refrigerated medications for diabetes and heart failure, such as Lantus Solostar insulin and Praluent). So, if they end up filling a smaller days' supply of a prescription like this than you expect, this could be the reason why—if the days' supply your provider wrote the prescription for OR what insurance limits you to would require that they break open a box, they'll fill the next smallest quantity that doesn't require them to do so. Similar to other situations described above, the best way to clarify why a prescription was filled in a days' supply you didn't expect is to call Express Scripts directly and ask why.
- If this is a deal breaker for you, the alternative would be to find a local pharmacy that would be willing to fill this medication at your prescribed/insurance limited days' supply and break open a box for you in doing so. If this is an expensive brand name drug, please try and fill it at a chain pharmacy, or confirm at an independent pharmacy that they won't lose money filling the prescription.