2026 Pharmacy

Penn State continually reviews employee benefits to provide faculty and staff with the highest quality and most affordable healthcare possible. While Highmark Blue Shield will remain the University’s third-party administrator for medical services, CVS Caremark will replace Express Scripts and Accredo as the University’s pharmacy provider.

  • Highmark and CVS Caremark will coordinate benefits to ensure accuracy of any plan deductibles that include both medical and prescription claims
  • CVS Caremark is the largest pharmacy benefit manager (PBM) in the United States with a national network of over 60,000 in-network pharmacies, including many chain and independent pharmacies.
    • You should not need a new pharmacy in most cases.
    • If your current pharmacy is participating with CVS Caremark, you will simply need to present your new card, for your prescription to be processed correctly under your updated prescription plan.
  • If your drug formulary status is changing between Express Scripts / Accredo as compared to CVS Caremark or CVS Specialty, CVS Caremark will be mailing letters to impacted member homes the week of November 24, 2025.
  • Welcome Kits will be mailed out mid- to late-December to employees including information regarding CVS Caremark and ID card(s) for every covered member.
  • Prior Authorization Information
    • Current PAs with Highmark will be honored with CVS Caremark.
  • Refill Information
    • Your existing prescriptions at retail pharmacies and/or University Health Services can be refilled after January 1, 2026; just present your new CVS Caremark ID card.
    • Refills through Express Scripts by mail and Accredo Specialty will be transferred to CVS Caremark or CVS Specialty; available for refill upon normal refill date on or after January 1, 2026.
  • Highmark/Express Scripts and CVS Caremark formulary listings do vary:

You are able to use the following tools to estimate the cost of your current medications. If you have any questions when reviewing these details, please contact CVS Caremark at the Penn State dedication phone number 1 (833) 298-7175.

Faculty, Staff, and Postdoctoral Appointees

Technical Service Employees

CVS Caremark Enhancements

Beginning with our change to CVS Caremark for January 1, there will also be several enhanced programs that we will be taking advantage of.

Retail 90

CVS Retail 90 allows covered members to get a 90-day supply of maintenance medications at a participating CVS Pharmacy, rather than a 30-day supply. This program is for medications you take regularly for chronic conditions, like high blood pressure or diabetes, and it offers cost savings and convenience by reducing the number of trips to the pharmacy. To use it, you need a 90-day prescription from your doctor, which you can then fill at a participating in-network pharmacy. 

Scripts written for 83 days or less can be filled as Retail 90 at an in-network pharmacy will result in the normal retail pharmacy coinsurance. Scripts written for 84 days up to 90 days can be filled as Retail 90 at an in-network pharmacy will result in the mail order pharmacy coinsurance.

Specialty Starter Fill

CVS Specialty Starter Fill is part of a program designed to help new or non-adherent patients start specialty medications more effectively. It provides a smaller initial supply, typically two weeks, to monitor adherence and manage potentially complex specialty drugs with frequent side effects or dose changes.

For a defined list of specialty drugs, new-to-therapy users and members who have not met adherence requirements receive a two-week supply initially. The CVS Caremark system will track member utilization of the medication. To receive a full month's supply of medication, members must accumulate a 60-day supply of the medication within a rolling six-month timeframe. Those who do not meet the 60-day requirement are considered new-to-therapy users and remain limited to the two-week supply.

The program reduces potential waste of high-cost specialty medications with high rates of side effects and frequent changes. It helps manage member adherence and care, which can lead to better outcomes while also aiming to provide cost savings for members.

ScriptSync

CVS ScriptSync is a program that coordinates your multiple eligible maintenance prescriptions so you can pick them up at the same time, usually in one monthly visit to the pharmacy. By aligning your prescription fill schedules, ScriptSync aims to improve medication adherence and convenience by making it easier for patients to get all their necessary medications together.

You can enroll by talking to a CVS pharmacist, and once set up, prescriptions are refilled on a recurring schedule, with notifications when they are ready. The pharmacist will work with you to identify your eligible maintenance medications and choose a single "synchronization date". For medications that will run out before the synchronization date, the pharmacist will provide "short fills" or additional days' supply to ensure all prescriptions are ready on that day. 

Once enrolled, your prescriptions are put on a 30-day, recurring schedule, and your eligible refills are coordinated for your chosen pick-up date. You'll receive a call or text message just before your ScriptSync pickup date, letting you know your order is ready.

Caremark Cost Saver

CVS Caremark Cost Saver is a program that automatically applies the lowest available drug price to many common, non-specialty generic medications, non-rebate eligible generic medications. Members don't need to do anything extra; their CVS Caremark ID card is all that is needed at the pharmacy to receive the benefit of the lower price at the point of sale.

All out-of-pocket costs paid through the Cost Saver program are applied to the member's plan deductible and out-of-pocket maximum. There's no need for the member to take any action, such as using a separate discount card or searching for prices online. 

Rx Savings Plus for Non-Covered Drugs (PENCD)

The CVS Rx Savings Plus for Non-Covered Drugs program is a discount program offered by CVS Caremark to provide savings on medications that are not covered by an individual's primary insurance plan. The savings are integrated directly into a member's existing pharmacy benefit plan. To receive a discount, a member simply needs to present their CVS Caremark benefit card and a prescription at a participating pharmacy.

Unlike many independent discount card programs, this program allows for critical safety measures, such as drug utilization reviews, by capturing member utilization data from each claim.

2026 Lion Traditional Prescription Coinsurance

Pharmacy Type Coinsurance Amount
Retail Pharmacy
(30-day supply or less)		 50% generic
50% preferred brand
70% non-preferred brand
ACA Preventive Drugs 0%
Preventive Drugs
(lower coinsurance)		 10% generic
20% preferred brand
40% non-preferred brand
Specialty Drugs Faculty, Staff, Postdoctoral Appointee
50% preferred brand, $100 maximum
70% non-preferred brand, $200 maximum

Technical Service
50% preferred brand, $50 maximum
70% non-preferred brand, $100 maximum
Retail 90 Pharmacy
(83-day supply or less)		 50% generic
50% preferred brand
70% non-preferred brand
Retail 90 Pharmacy
(84-day supply up to 90-day supply)		 20% generic
20% preferred brand
70% non-preferred brand
CVS Mail Order 20% generic
20% preferred brand
70% non-preferred brand

 

2026 Lion Advantage

Pharmacy Type Coinsurance Amount
Retail Pharmacy
(30-day supply or less)		 10% generic
20% preferred brand
40% non-preferred brand
ACA Preventive Drugs 0%
Preventive Drugs
(no deductible, coinsurance only)		 10% generic
20% preferred brand
40% non-preferred brand
Specialty Drugs 20% preferred brand, $65 minimum
40% non-preferred brand, $100 minimum
Retail 90 Pharmacy
(83-day supply or less)		 10% generic
20% preferred brand
40% non-preferred brand
Retail 90 Pharmacy
(84-day supply up to 90-day supply)		 10% generic
20% preferred brand
40% non-preferred brand
CVS Mail Order 10% generic
20% preferred brand
40% non-preferred brand

Register at Caremark.com or the CVS Health mobile app

When you register at Caremark.com, you’ll get access to tools and resources. There are three easy ways to register:

  • Go to Caremark.com, click the Register button and follow the instructions to sign up
  • Download the CVS Caremark® mobile app from Google Play or the App Store to register your account
  • Call the number on the back of your member ID card and a representative will get you started with a personalized registration email or text

Register to:

  • Refill your prescription
  • Check the status of your order
  • Review your coverage and track annual spending
  • Locate network pharmacies near you
  • Check medication costs and find opportunities to save money
  • Log into Caremark.com from your desktop to access these additional features: manage your profile information, including shipping addresses, payment methods, and notifications

The CVS Health® app provides access to everything you need, all in one place. Now, it’s faster and easier than ever to keep track of retail pharmacy, mail order and specialty prescriptions, securely access plan benefits, and enjoy savings right from your phone with the upgraded mobile app.

  • Manage prescriptions: View orders, locate in-network pharmacies, and request refill delivery or pickup using a scannable barcode** in the app. You
    can even check the status on a prior authorization request.
  • Find helpful tools & info: Check and compare drug costs across in-network pharmacies to find possible savings. You can view your ID card and track current
    deductible and copay amounts, too.
  • Get answers & support: Need help with a complex condition or medication guidance? CVS Caremark is here for you and your family. And if someone helps manage your health, you can grant them access right in the app.