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  • Express Scripts Physician Mail Order Form - Www2 Illinois

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New Prescription. YOUR PATIENT WOULD LIKE TO RECEIVE THEIR PRESCRIPTION MEDICATION BY MAIL. 34202. Please complete ALL information below.

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How do I send Express Scripts a new prescription? Your doctor's office can send your prescription to us electronically from their office or by fax. Go to Forms & Cards under Benefits in the top menu of the home page and select the appropriate form. your prescription to the address listed.

Express Scripts® Pharmacy is a trademark of Express Scripts Strategic Development, Inc.

Express Scripts® Pharmacy is a pharmacy that is contracted to provide mail pharmacy services to members of Blue Cross and Blue Shield of Illinois.

BCBSIL utilizes Prime Therapeutics LLC as our pharmacy benefit manager to administer our pharmacy program to help contain rising drug costs and maintain and improve the quality of care delivered to members.

Call Express Scripts at 877-603-1032, and let them do all the work. For most medications, Express Scripts will be able to contact your doctor and arrange for your first mail-order supply. Ask your doctor for a new prescription for up to a 90-day supply, plus refills for up to one year (if appropriate).

Preferred network pharmacies include Jewel-Osco, Kroger, Mariano's, Walgreens, Walmart, and other independent pharmacies. Check your plan's pharmacy directory for a full list of preferred pharmacies.

Most medications covered through Express Scripts will be covered through Optum Rx. To check if your medication is covered refer to the formulary posted on .bcbsm.com/uawtrust. If your medication is not Page 3 covered, Optum will allow for a non-formulary medication to be covered as a transitional fill.

Express Scripts is an online pharmacy and a pharmacy benefit manager. We make prescription medications safer and more affordable for our members. We handle millions of prescriptions each year through home delivery from Express Scripts Pharmacy®.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232