Express Scripts Will No Longer Fill Prescriptions Written for Less Than a 35-Day Supply

Effective Jan. 1, 2026, Express Scripts® Pharmacy Home Delivery will require providers to prescribe medications* for an extended day supply (at least 35-day supply) for members in our Commercial, Medicare, and Affordable Care Act (ACA) products.:

IMPORTANT: Providers who send a prescription to Express Scripts Pharmacy for less than 35-day supply for impacted medications will have to reissue the prescription for an extended day supply or send it to an in-network retail pharmacy.

For members with prescriptions that are less than a 35-day supply, Highmark recommends the following:

• For patients utilizing Home Delivery for short-term medications: Highmark encourages providers to send these prescriptions to a convenient in-network retail pharmacy location. 

• For patients utilizing Home Delivery for maintenance medications: Highmark encourages providers to consider updating prescriptions to an extended days’ supply if clinically appropriate and sending to Express Scripts Pharmacy Home Delivery or to an in-network retail pharmacy location. For maintenance medications, providers can prescribe up to a 100-day supply for most Tier 1 and Tier 2 medications. 

*Exceptions include drug classes where consolidation or a longer day supply is not appropriate, such as state and federally controlled drugs, over-the-counter medications, diabetic supplies, and some maintenance medications (mood-altering medications, sublingual nitroglycerin, albuterol inhalers, or warfarin).