This page only applies to plan participants enrolled in HealthLink OAP, Coventry Health Care OAP or the Quality Care Health Plan.
Maintenance medication is medication taken on a regular basis for conditions such as high blood pressure and high cholesterol.
- Plan participants will receive the most economical benefit when they use either the mail order pharmacy (i.e., Medco Pharmacy™) or a pharmacy that is in the Maintenance Network. View this link for a list of pharmacies in the Illinois Maintenance Network or a listing of Maintenance Pharmacies Outside of Illinois.
- Plan participants can receive a 61-90 day supply of medication (equivalent to 3 fills) for only two copayments when using the Maintenance Network or the mail order pharmacy (i.e., Medco Pharmacy™). Note: Effective July 1, 2013, a 90-day supply of medication will be 2.5 times the copayment amount for the mail order pharmacy and for medications filled at a retail maintenance network pharmacy.
- In order to obtain maintenance medication through a Maintenance Network Pharmacy or the mail order pharmacy (i.e., Medco Pharmacy™), plan participants must submit an original prescription from their attending physician for a 61-90 day supply, and include up to three (3) 90-day refills, totaling one year of medication in order to receive their fill for only two copayments, or if filled after July 1, 2013, for two and half copayments.
- Participants who do not receive their maintenance medication through either of these two options and instead obtain their medication through a retail pharmacy will be charged double the copayment rate after the first two 30-day fills of medication.
- Both maintenance and nonmaintenance medications may be obtained through the mail order pharmacy (i.e., Medco Pharmacy™). Plan participants interested in receiving a 90-day supply through mail order may either complete the Medco Mail Order form and submit with the original prescription, or ask their physician to complete the Express Scripts Mail Order form and fax to Express Scripts on their behalf.
To determine whether a medication is considered a maintenance medication, contact Express Scripts at (800) 899-2587.
Use this link to view information regarding nonmaintenance medication pharmacy options. Return to Express Scripts Prescription Benefit page.