You are hereHealth Care Trust

Health Care Trust

The Montana Association of Counties Health Care Trust was established in 2005 to provide a cost-effective alternative for health insurance benefits for counties and county-related boards and districts. By pooling the risk of a severe financial loss over a larger population, premiums are generally more stable, limiting the broad fluctuations that an individual county or district might otherwise experience.

The Health Care Trust is able to combine the purchasing power of pool members when negotiating plan services, such as claim management, case management, preferred provider pricing, and reinsurance. The result is favorable coverage, terms, conditions, and plan limits that are tailored to the needs of the county, board, or district.

Plan services such as enrollment, risk control, and wellness programs are tailored to the needs of county members. Health Care Trust members have a significant voice in how the pool is operated and how claims are resolved, since the policy-making board is comprised of county commissioners. If claims controversies should arise, Health Care Trust members have the full support of MACo administration and the Health Care Trust board.

Staff        Telephone Numbers & Addresses



Beginning January 1, 2019 MACoHCT will begin partnering with Express Scripts to manage the prescription drug plan.

All members enrolled in a MACoHCT Medical/Rx Plan will receive a new MACoHCT ID Card in mid-December. Please be certain to present your new MACoHCT ID Card at the pharmacy counter beginning January 1, 2019.

MACoHCT members can access the Express Scripts website, mobile app and dedicated member service toll-free number beginning January 1, 2019.  •  (877) 819-4026

Prior to January 1, 2019 information regarding Express Scripts’ network pharmacies, Preferred Formulary Drugs, and a list of Excluded Drugs & Preferred Alternative Drugs can be found here.

Important Note: With the transition from CVS Caremark to Express Scripts, some members may find that their current medications may change copayment tiers or may be excluded from coverage if a less expense, equivalent medication is available. To see if your current medications will be considered a Preferred Brand-Name prescription with Express Scripts, please view this website. If you find that your current medication is not considered a Preferred Drug, you are strongly encouraged to visit with your physician to see if an alternative, Preferred Drug is appropriate for you to try.


One of the best things about mail order, home delivery is that Express Scripts ships up to a 90-day supply of your long-term medicine (the kind you take regularly) right to your door from the Express Scripts PharmacySM. It’s safe, secure and speedy – and means less time in a pharmacy line!

Prescriptions with open refills can be transferred to the Express Scripts Pharmacy from your current home delivery pharmacy except for controlled substances and compound medications. Call Express Scripts, go to the Express Scripts website or Express Scripts mobile app to order your medications beginning January 1, 2019.

Here’s a quick look at the benefits of Home Delivery:

  • Free standard shipping
  • Up to a 90-day supply of your long-term medicines delivered to your home
  • 24/7 access to a pharmacist from the privacy of your home
  • Order your refills online or on the phone


A Preferred Drug List helps keep healthcare costs down for everybody. It's a list of medicines that have been reviewed and approved for safety, effectiveness and cost by a panel of doctors and pharmacists. This list is continually reviewed and updated as new medicines become available.

2019 Preferred Drug List

Note that certain brand-name medicines are excluded from the Preferred Drug List and therefore not covered due to equally effective and safe alternatives being available. If you’re currently taking a medicine that is not included on the Preferred Drug List, it is highly recommended that you visit with your physician to see if a Preferred Drug is appropriate for you to try. If your physician determines that it is necessary for you to continue to take a Non-Preferred and/or Excluded Drug, a prior-authorization for medical necessity may be submitted by your physician to Express Scripts.


Network pharmacies are retail pharmacies that are preferred by Express Scripts. MACoHCT members have access to 60k+ network pharmacies located across the United States. Up to a 90day supply of your long-term medicines can be filled at all network retail pharmacies in Montana.  

To find an in-network pharmacy near you, visit this website at anytime.

Be sure to show your new MACoHCT ID Card at the pharmacy counter beginning January 1, 2019. If you need to transfer your prescription from an out
of network pharmacy to an in-network pharmacy, just choose one of the following:

  • Bring your prescription to an in-network pharmacy, and the pharmacist will transfer it
  • Call a network pharmacy, and ask the pharmacist to transfer your medicine
  • Ask your doctor to call your prescription in to an in-network pharmacy


One of the great things about being an Express Scripts member is that you can manage your medicine easily on your laptop, tablet, desktop or phone. Whether you want to check your order status, look for savings opportunities, look up information about your benefit, get a refill or even find a pharmacy, the Express Scripts app can help!

Just register at or on the app beginning January 1, 2019.

You can download the app on your phone by searching your app store for Express Scripts.


Accredo® is the Express Scripts specialty pharmacy. A specialty pharmacy provides medicine and therapy for patients with serious, chronic conditions like cancer and hepatitis C. Accredo offers specialized teams of pharmacists, nurses and clinicians who are specially trained on your condition. This level of specialization gives you the most comprehensive, compassionate and customized care available.

Accredo offers many specialized services, including:

  • Personal care and health advocacy assistance from patient care coordinators
  • Financial assistance (availability varies by plan)
  • Guidance for patients and caregivers for taking specialty medicines most effectively
  • All necessary ancillary supplies such as syringes and sharps containers

Beginning January 1, 2019 Specialty medications must be filled through Accredo. To learn more about Accredo, please visit or call Express Scripts at (877) 819-4026 beginning January 1, 2019.