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 (Domestic) Pharmacies

ESI (Non-Domestic) Pharmacies

Generic

$15 copay

$15 copay

Formulary Brand

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

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

Non-Formulary Brand

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

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

Maintenance, 

90-day supply

Endeavor Health Pharmacies,
In-Person or Mail

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

Endeavor Health Pharmacies, 
In-Person or Mail

ESI (Non-Domestic)
Pharmacies

Generic

$50

Exceptions Only

Preferred Brand, 

Biosimilar

$150

Exceptions Only

Non-Preferred

$250

Exceptions Only

2024 Express Scripts Formulary

Rx Out-of-Pocket Maximum

  • NS-EEH System 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 your prescriptions in 2024 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.  


  • EPO Plan: Your charge for prescription drugs follows the above pricing on day one, and your costs count towards your medial plan’s out-of-pocket maximum. There is a shared out-of-pocket maximum for both medical and prescription drug costs: for the Domestic network, this is $4,500 per person up to $9,000 per family. For the Cigna network, the maximum is $9,000 per person up to $18,000 per family.

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 domestic pharmacies, CVS, and other ESI network pharmacies.



Long-term (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 domestic pharmacy or CVS pharmacy
  • Fill by mail from Skokie Hospital Outpatient Pharmacy

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.

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