Coverage is administered by CVS Caremark. You can fill short-term medications at any of the 68,000 participating pharmacies—including 7,500 CVS/pharmacy locations—nationwide, while you can fill maintenance medications via the Maintenance Choice program or at any participating retail pharmacy by opting out of the Maintenance Choice program (see below).
- See the Summary of Coverage or contact CVS Caremark for details regarding your prescription coverage.
- If you are enrolled in the Choice Plus Plan with HSA, you will be required to pay the full cost for your medications until you reach your annual plan deductible. After you meet the deductible, you pay only the co-pay until you reach the annual out-of-pocket maximum. However, this deductible rule does not apply if you take medications on the Preventive Therapy Drug List—you pay only the copay for these medications even if you have not yet met your deductible.
- The State plan covers a variety of preventive prescriptions and products at no cost to you and any covered dependents. See CVS Caremark® Preventive Services List for complete detail on what is covered. (Note: Your doctor must write a prescription for these preventive services to be covered by your plan, even if they are listed as over-the-counter.)
Maintenance Choice (with opt-out)
Starting January 2017, you are automatically enrolled in the Maintenance Choice program, where you can save money by obtaining 90-day supply of maintenance medications for the price of 60-day co-pay. (This program does not apply to short-term/acute medications.)
You are not required to use CVS/pharmacy to fill your maintenance medications. If you want to fill 30-day supplies of your maintenance medications at your preferred non-CVS pharmacy, you can opt out of the program by contacting CVS Customer Care at 1-800-307-5432.
To obtain a 90-day supply of maintenance medications:
- Register at www.caremark.com, or
- Complete and send a CVS Caremark Mail Order Form, or
- Pick up at a CVS Pharmacy or select Target stores.
You are recommended to always use pharmacies within your network. To obtain reimbursement for out-of-network prescription claims, complete the CVS Caremark Rx Claim Form and submit as instructed on the form.