Summary of Prescription Drug Plans

Summary of Prescription Drug Plans

You will be automatically enrolled in the prescription drug plan, administered by Express Scripts (ESI), if you enroll in one of the Endeavor Health medical plans.


Short Term, 

30-day supply

Endeavor Health Outpatient Pharmacies

ESI Retail Pharmacies

Generic

$15 copay

$15 copay

Formulary Brand

You pay 20%
min: $50, max: $80

You pay 30%
min: $70, max: $120

Non-Formulary Brand

You pay 30%
min: $80, max: $150

You pay 40%

min: $100,
max: $200

GLP-1 Drugs
(for weight loss)

$200 copay

Supply-related
exceptions only

Maintenance, 

90-day supply

Endeavor Health
Outpatient Pharmacies or Mail Order

CVS Retail
In-Person Only

Generic

$25 copay

$45 copay

Formulary Brand

You pay 20%
 min: $85, max: $150

You pay 25%
min: $125, max: $225

Non-Formulary Brand

You pay 30%
min: $160, max: $225

You pay 35%
min: $250, max: $300

Specialty, 
30-day supply

Endeavor Health

Outpatient Pharmacies or Mail Order

CVS Retail

In-Person Only

Generic

$50

Supply-related

exceptions only

Preferred Brand, 

Biosimilar

$150

Supply-related

exceptions only

Non-Preferred

$250

Supply-related

exceptions only

Rx out-of-pocket maximum

  • Endeavor Health Plan: Your charge for prescription drugs follows the above pricing on day one. However, prescription drugs in this plan have a separate annual maximum of $2,000 per person, up to $4,000 per family. This means the most you will pay for covered prescriptions in 2025 is $2,000 per person, up to $4,000 per family. Prescription drug costs do not count towards your medical plan’s out-of-pocket maximum.


  • HDHP: You must fulfill your deductible before the above pricing begins. Your costs for prescription drugs count towards your medical plans' annual deductible and out-of-pocket maximum (either Endeavor Health or Cigna, depending which pharmacy you use.)


  • EPO Plan: Your charge for prescription drugs follows the above pricing immediately, and your costs count towards your medical plans' out-of-pocket maximum (either Endeavor Health or Cigna, depending which pharmacy you use.)


HDHP members pay the full cost of medications until the deductible is met. Once you meet the deductible, you will pay the coinsurance shown above. You can use funds in your Health Savings Account to pay for your medications—before and after you meet the deductible.


Please remember that you will generally pay lower out-of-pocket costs when utilizing Endeavor Health Outpatient pharmacies.


The Endeavor Health Outpatient Pharmacies are located at:

  • Edward Hospital
  • Elmhurst Hospital
  • Evanston Hospital
  • Glenbrook Hospital
  • Highland Park
  • Northwest Community Healthcare
  • Skokie Hospital
  • Swedish Hospital Foster Medical Pavilion
  • Swedish Hospital Galter Medical Pavilion


Short-term (30-day supply): Prescriptions can be filled in-person at Endeavor Health Outpatient pharmacies, CVS, and other ESI network pharmacies.


Maintenance (90-day supply): Prescriptions for chronic conditions, as well as specialty medications, must be filled as a 90-day supply after the third 30-day fill. You have two options:


  • Fill in-person at an Endeavor Health Outpatient pharmacy or CVS pharmacy
  • Fill by mail from Skokie Hospital Outpatient Pharmacy


Evanston Hospital Outpatient Pharmacy 

  • 2650 Ridge Ave #G949 Evanston, IL 60201
  • 847-570-2210
  • 9AM-6PM M-F, 9AM-3PM Saturdays, Closed Sundays


Glenbrook Hospital Outpatient Pharmacy

  • 2100 Pfingsten Rd #1092 Glenview, IL 60026
  • 847-657-1785
  • 9AM-6PM M-F, 9AM-3PM Saturdays, Closed Sundays 


Highland Park Hospital Outpatient Pharmacy

  • 777 Park Ave West #1421 Highland Park, IL 60035
  • 847-926-6560
  • 9AM-5PM M-F, Closed Saturdays and Sundays


Skokie Hospital Outpatient Pharmacy

(Mail order available) 

  • 9650 Gross Point Rd #1901 Skokie, IL 60076
  • 847-933-6890
  • 9AM-6PM M-F, 9AM-3PM Saturdays, Closed Sundays


Swedish Hospital Foster Medical Pavilion Outpatient Pharmacy

  • 5215 N California Ave #F103 Chicago, IL 60625
  • 773-989-6280 
  • 10AM-6PM M-F, 9AM-3PM Saturdays, Closed Sundays


Swedish Hospital Galter Medical Pavilion Outpatient Pharmacy

  • 5140 N California Ave #G105 Chicago, IL 60625
  • 773-989-3980
  • 9AM-6PM M-F, 9AM-3PM Saturdays, Closed Sundays


Northwest Community Healthcare Outpatient Pharmacy

  • 800 W Central Rd #1100 Arlington Heights, IL 60005
  • 847-618-7427
  • 8AM-6PM M-F, 10AM-3PM Saturdays, Closed Sundays 


Edward Hospital Outpatient Pharmacy 

  • 100 Spalding Dr. #101 Naperville, IL 60540
  • 630-527-5204
  • 8AM-6PM M-F, Closed Saturdays and Sundays


Elmhurst Hospital Outpatient Pharmacy 

  • 155 E. Brush Hill Road #D1543 Elmhurst, IL 60126
  • 331-221-3500
  • 9AM-5PM M-F, Closed Saturdays and Sundays