Pharmacy Programs
- 2013 CVS Caremark Pharmacy Programs
- Mail Service Pharmacy— Standard Option Only
- Generic Incentive Program
- Using the Mail Service Pharmacy is easy
- Retail Pharmacy Program— Both Options
2013 CVS Caremark Pharmacy Programs
Use the CVS Caremark FEP tools to look up drugs covered by your benefit plan. Find out whether generic drugs or brand-name drugs with a lower cost share might help you save money.
Mail Service Pharmacy— Standard Option Only
The Mail Service Pharmacy Program for Standard Option is an easy way to obtain medications you take every day for a chronic condition with the convenience of home delivery.
If you have any questions about the Mail Service Pharmacy or want to talk to a pharmacist about your medications, you can call 1.800.262.7890 anytime. This benefit is not available under Basic Option.
If you are a Standard Option member and you use a Preferred retail pharmacy or the mail service pharmacy you may be able to save even more with the Standard Option Generic Incentive Program.
Under this program, we will waive the coinsurance or copayment amount for the first four prescription fills when you switch from certain brand-name drugs to specific generic drugs. The average savings under the Generic Incentive Program is $30 to $60 per prescription fill or refill.
Using the Mail Service Pharmacy is easy
- Ask your physician to prescribe up to a 90-day supply (minimum 21-day supply) of your medication plus refills for up to one year.
- Send your original prescription, the appropriate copayment amount and your completed mail service order form to the address on the form. You can request order forms online or by calling 1.800.262.7890.
- Or you can ask you doctor to order a prescription for you by calling 1.800.262.7890 and pressing Option 1.
- All medications and instructions are sent via US Postal Service, except for medications that require overnight shipping. You should receive your prescription within 14 days from the time you mail in your order.
- You can order refills by sending in the refill slip included with your previous prescription fill, you can order refills online under Pharmacy Programs, or you can call 1.877.337.3455 24/7 to order your refills.
Retail Pharmacy Program— Both Options
Basic Option members must use a Preferred retail pharmacy or our Internet pharmacies to obtain medications. Standard Option members can use any Preferred or Non-preferred local retail pharmacy or Internet pharmacy. However, if you use a Non-preferred pharmacy, you pay the full cost of the drug and then file a claim for reimbursement. Your cost share is 45 percent of the Average Wholesale Price, plus any difference between our allowance and the billed amount.
Just show your Service Benefit Plan ID card at a Preferred pharmacy. You pay only the appropriate copayment or coinsurance amount. If you have any questions about the Retail Pharmacy Program, you can call 1.800.624.5060 to talk to a member service representative.
We have over 60,000 Preferred Network retail pharmacies nationwide along with our Internet Pharmacies. You can locate a Preferred retail pharmacy near you by calling 1.800.624.5060 or by using the Provider Directory.
BENEFIT | 2013 STANDARD OPTION COVERAGE | 2013 BASIC OPTION COVERAGE |
|---|---|---|
| Mail Service Pharmacy | Up to a 90-day supply. Nothing for the first four prescription fills or refills when you switch from certain brand-name drugs to specific generic drugs.
Tier 1 (generics): $15 copayment. Tier 2 (Preferred brand-name): $70 copayment. Tier 3 (Non-preferred brand-name): $95 copayment. | Not a benefit. |
| Retail Pharmacy Program | Up to a 90-day supply. Nothing for the first four prescription fills or refills when you switch from certain brand-name drugs to specific generic drugs when you use a Preferred Pharmacy.
Tier 1 (generics): 20% PPA. Tier 2 (Preferred brand-name): 30% PPA. Tier 3 (Non-preferred brand-name): 45% PPA. | Up to a 34-day supply. 90-day supply for 3 copayments.
Tier 1 (generics): $10 copayment. Tier 2 (Preferred brand-name): $40 copayment. Tier 3 (Non-preferred brand-name): 50% coinsurance or $50 minimum. |
Page last updated: November 14, 2012