Choosing a pharmacy or home delivery

We expect that the drugs on the Approved Drug List (formulary) for your plan will meet all your prescription drug needs. However, if your doctor prescribes a drug that's not on your plan's Approved Drug List, we may still approve it for you. 

Here's the process for asking for an exception to the formulary:

  1. Your doctor will fill out a drug authorization request form that explains why you need the non-formulary drug.
  2. Priority Health will let you and your doctor know, within 24 hours of receiving all information we need to make a decision, whether or not we approve the drug for you.
  3. If you are not happy with the determination, you or your representative have the right to request a decision by an Independent Review Organization (IRO).
  4. Priority Health has 72 hours to get an IRO decision, or 24 hours to get an IRO decision if waiting 72 hours may seriously jeopardize your life or health or your ability to regain maximum function or when you are undergoing a current course of treatment using a non-formulary drug. Priority Health will cover the non-formulary drug during the review period and for as long as required by law.

If you're on a daily medication, then using Express Scripts home delivery with your mail order benefit will save many trips to the pharmacy and out-of-pocket costs.*

  • Regular shipping is free.
  • Your first order will arrive within 14 days of when Express Scripts receives it.
  • Refills arrive in 7 to 10 days.

How to get started

Express Scripts has made it easy. Send in your prescription in one of three ways:

  • Ask your doctor to e-prescribe a 3-month supply to Express Scripts Mail-Order Delivery.
  • If you've had your existing medication filled at a retail store, after setting up your online account with Express Scripts, you’ll have the option to “Transfer to Home Delivery.”
  • Have your provider submit prescriptions using electronic submission or have them contact ESI Mail Order via phone at 866.384.6494. Your provider can also submit prescriptions via fax at 800.837.0959.

Refills are easy

After you receive your first order, life's even easier. Just go to express-scripts.com and click a button to order your refill (or set up automatic refills). Or you can call to order your next 3-month supply. For quick and easy ordering over the phone, have the prescription label with you.

When you have no refills left, Express Scripts will contact your doctor to find out if your prescription should be renewed.

Order prescriptions online:

Visit express-scripts.com to:

  • Register your account
  • Order new prescriptions
  • Set up auto refills
  • Order refills
  • Pay with your American Express®, Discover Card®, MasterCard® or Visa®.

Order by phone:

Call Express Scripts at 888.378.2589.

Order by mail:

  • Have your provider submit prescriptions using electronic submission or have them contact ESI Mail Order via phone at 866.384.6494. Your provider can also submit prescriptions via fax at 800.837.0959.

You can also sign up for an online account at express-scripts.com. When setting up an account, use your Priority Health member ID with no spaces or dashes as your Express Scripts User ID. You can also call ESI Mail Order directly at 888.378.2589.

*Check your plan documents to verify your mail order benefits