Pharmacy Benefits
CVS Caremark is the nation's premier integrated pharmacy services provider, combining one of the nation's leading pharmaceutical services companies with the country's largest pharmacy chain. The company fills or manages more than one billion prescriptions per year, more than any other pharmacy services provider.
Note: Not all benefit plans are the same. If you want to use a national chain pharmacy, please know that your benefit may restrict the pharmacy that you use. You should always check with your pharmacy to see if it is part of our network before you have your prescriptions filled.
Benefit Plans
Your prescription drug card program makes it easy for you to receive the prescriptions you need. When you use a participating network pharmacy, you’ll have NO claim forms to file and NO waiting for reimbursement.
Mail service is ideal if you take prescription drugs on an ongoing or regular basis. When you use the Caremark Mail Service Pharmacy, you can save on the prescriptions you take.
Drug Lists
Members are engouraged to consider generic drugs to save the most on their prescription drug costs. Generics are available to treat many conditions and many people find them to be a good choice. In fact, nearly eight out of every 10 prescriptions are now filled with generics. View a list of popular brand-name drugs with generic equivalents or enter the name of a brand-name drug in the drug lookup tool.* If there's a generic alternative to a brand-name drug you take, ask your doctor if it's right for you.
A Preferred Drug List (PDL) is a list of prescription medications chosen for their clinical value and cost-effectiveness by an independent panel of physicians and pharmacists. With our PDL, you and your doctor have the freedom to choose the medication that works best for you. Talk to your doctor about generic and preferred brand-name drugs whenever possible to help manage your prescription costs. Use our drug lookup tool* to search for a specific drug.
Specialty Drugs are prescription medications that are used to treat complex or chronic medical conditions like cancer, rheumatoid arthritis, multiple sclerosis and hepatitis, just to name a few. They are often self-injected and usually require patient-specific dosing and careful clinical monitoring. They may also require special handling and refrigeration.
CuraScript Specialty Pharmacy is our preferred specialty pharmacy vendor. On behalf of PAI, CuraScript will administer this program. CuraScript is an independent company that dispenses specialty drugs and provides other related services.
Drug Management
Many of our plans have drug management programs for members. Not all benefit plans are the same. Please check your benefit information to find out which programs apply to you.Makes your medication plan easier to follow by lowering the number of tablets you have to take each day. You can see the drugs included in the program by viewing our Dose Management Drug List.
Certain medications may require prior authorization. If your doctor prescribes a medication that is included in our Prior Authorization program, you must get prior approval before your plan will cover your medication.
Limits the amount of certain drugs a member’s plan will cover. You can see which drugs have quantity limits by viewing our Quantity Limit Drug List.
Requires members to try cost-effective “First Choice” medications before trying (or "stepping up to") more expensive “Second Choice” medications. Many people find the First Choice medications work just as well for them. View the Step Therapy Drug List.
Forms
To order up to a 90-day supply of prescriptions through Caremark's Mail Service prescription program.
To file claims for covered prescriptions for which you paid 100 percent, for covered prescriptions you received without showing your ID card, and for covered prescriptions you received from a non-participating pharmacy.
Resources
Use this tool to find out how much a prescription drug will cost. The tool will also inform you if there's a generic available, giving you the opportunity to save money.
A general listing of most our benefit plans' participating pharmacies. Members may also search for a pharmacy by ZIP code, state, or distance from a specific address by visiting Caremark's Web site.* You can also search for pharmacies that offer special services, like delivery or extended hours of operation.
* This link leads to a third party website. Caremark, an independent company, is solely responsible for the contents and privacy policy on its site.