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FutureScripts offers the convenience of a mail order pharmacy benefit. Day or night, participants can fill long-term and maintenance prescriptions and have their medications shipped directly to their front door from FutureScripts' mail order delivery.
In addition to the ease of ordering from home, plan participants may also save money. When filling long-term and maintenance medications through the FutureScripts Mail Order Program, participants may receive an extended supply of their drugs for a lower copay.
To submit new prescriptions that will be filled through the FutureScripts Mail Order Program, please complete the appropriate Mail Service Order Form and send it to FutureScripts at the address provided on the form. Please note that completion of this form is not a guarantee of benefit coverage.
- FutureScripts members with Independence Blue Cross (IBC) or AmeriHealth coverage:
Mail Service Order Form
Mail Order Health Questionnaire*
- FutureScripts members with AmeriHealth Administrators (AHA) or Independence Administrators (IA) coverage:
Mail Service Order Form
Mail Order Health Questionnaire*
- AAA members/FutureScripts Direct coverage:
Mail Service Order Form
Mail Order Health Questionnaire*
- FutureScripts Secure members with Medicare Part D coverage:
Mail Service Order Form
Mail Order Health Questionnaire*
* If this is your first time using the new FutureScripts mail order service, please note you must also complete a confidential Health, Allergy, and Medication Questionaire (HMQ), and mail it to the address listed on the form. To help us protect you against potentially harmful drug interactions and drug allergies, it’s important that you complete this form the first time you use your mail order service and any time you have a change in health status or medication use. Be sure to indicate any non-prescription (over-the-counter) medications you may be taking.