Submitting new prescriptions
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Once you are certain your pharmacy benefit includes a mail order component, you can send your prescription to your Medco mail order pharmacy one of three ways:

by fax:
Have your physician fill out this fax form, and follow the instructions to send it in to us.

Note: This fax form requires Adobe® Reader® to print. If you need to download or install, click the icon below.

Get Acrobat Reader

IMPORTANT: Only your physician may fax the completed form to us.

Your doctor may also obtain fax forms and instructions directly by calling 1-888-EASYRX1 (1-888-327-9791). This number is for physicians only.

Please note: a special fax form is required in the state of Virginia. If you or your doctor are located in Virginia, ask your doctor to obtain the correct form by calling the number listed above.

by mail:
Mail in a prescription your physician has written using our online mail order form. To access our online form, click here and simply follow the instructions on how to download, print and mail in your completed home delivery form with any new prescriptions.

Find out if your plan sponsor allows you the flexibility to request new prescriptions right here at our website, by clicking the register now button below.

register now

To use this service, you must have previously discussed your prescription request with your prescriber. Your prescriber must also indicate approval before we will contact him/her. Please note that controlled substances including narcotics are not eligible for this service. If you would like us to request a prescription for you, you may do so by completing our online request form. Once completed, we will submit your request to the prescriber you indicate. Please note that your request will not be filled or shipped until your physician indicates approval of this request by submitting a prescription to us.

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