Prescription Coverage
For 2018, the prescription benefit provider will change to CVS Caremark. CVS Caremark is a leading pharmacy benefits manager with nearly 90 million plan members, nearly 9,700 retail locations, and more than 1,100 walk-in medical clinics. CVS Caremark offers a dedicated senior pharmacy care business serving more than one million patients per year, expanding specialty pharmacy services, and a leading stand-alone Medicare Part D prescription drug plan, the company enables people, businesses and communities to manage health in more affordable and effective ways. This unique integrated model increases access to quality care, delivers better health outcomes and lowers overall healthcare costs.
- PPO Plan Faculty/Staff Pharmacy Pricing Tool
- PPO Plan Technical Service Pharmacy Pricing Tool
- PPO Savings Plan Pharmacy Pricing Tool (Before Deductible Met)
- PPO Savings Plan Pharmacy Pricing Tool (After Deductible Met)
- Pharmacy Locator Tool
- CVS Caremark Formulary
- Diabetic Supply Coverage
Mail Order Forms
The transition to CVS Caremark does not mean you can only use CVS pharmacies. You can fill your prescriptions:
- At various chain and independent retail pharmacies (30-day supply).
- At University Health Services (30 or 90-day supply).
- Through CVS Caremark mail order services.
- Via CVS Specialty if you are on a specialty medication.
| Retail (30-day supply) | |
|---|---|
| Generic Drugs | 10% coinsurance |
| Formulary Brand Drugs | 20% coinsurance |
| Non-Formulary Brand Drugs | 40% coinsurance |
| Mail Order | |
| Generic Drugs | 10% coinsurance |
| Formulary Brand Drugs | 20% coinsurance |
| Non-Formulary Brand Drugs | 40% coinsurance |
| Specialty | |
| Formulary Drugs | 20% and $65 Minimum |
| Non-Formulary Brand Drugs | 40% and $100 Minimum |
| Out-of-Pocket Maximum | Integrated with Medical |
PPO Plan Prescription Coverage for Technical Service
| Generic Drugs | 50% coinsurance |
| Formulary Brand Drugs | 50% coinsurance |
| Non-Formulary Brand Drugs | 70% coinsurance |
| Mail Order | |
|---|---|
| Generic Drugs | 20% coinsurance |
| Formulary Brand Drugs | 20% coinsurance |
| Non-Formulary Brand Drugs | 70% coinsurance |
| Specialty | |
| Formulary Drugs | 50% and $50 Maximum |
| Non-Formulary Brand Drugs | 70% and $100 maximum |
| Out-of-Pocket Maximum | $1,000/$6,000 |
| Pharmacy | ||||
|---|---|---|---|---|
| Retail (30-day supply) | ||||
| Generic Drugs | 50% coinsurance | |||
| Formulary Brand Drugs | 50% coinsurance | |||
| Non-Formulary Brand Drugs | 70% coinsurance | |||
| Mail Order | ||||
| Generic Drugs | 20% coinsurance | |||
| Formulary Brand Drugs | 20% coinsurance | |||
| Non-Formulary Brand Drugs | 70% coinsurance | |||
| Specialty | ||||
| Formulary Drugs | 50% and $50 Maximum | |||
| Non-Formulary Brand Drugs | 70% and $100 maximum | |||
| Out-of-Pocket Maximum | $2,000/$8,000 | |||