Prescription Drug Plan

CVS Caremark logo

http://www.caremark.com
(active employees only)
(866) 260-4646

Specialty Pharmacy Web Site:
https://www.cvsspecialty.com/wps/portal/specialty

CVS Caremark Prescription Plan Highlights

Copayments for generic, preferred and non-preferred brand prescription drugs, are per the following schedule:                         

Prescription Drug Class

30-Day Supply – Retail
(Any Retail Pharmacy)        

90-Day Mail Order
90-Day CVS/Pharmacy  (only)

Generics

$13

$21

Preferred brand

$25

$45

Non-preferred brand

$40

$65

  • Maintenance Choice Program – plan participants who take maintenance medications have the choice to purchase their 90-day supply from the mail order program or from a CVS/Pharmacy store and pay the same mail order copayment.
  • Mandatory Generics – required when available as well as using the mandatory specialty pharmacy program or specialty prescription drugs. Recognizing that there are times when a patient cannot take a generic, FCPS has established a Formulary Exception Process. This process requires a member to try a number of generic drugs, under the direction of their physician. Should those generic drugs not be appropriate for the member’s condition, an exception for a brand drug/non-formulary drug can be approved for limited time period. If you believe this applies, you or your physician may contact CVS Customer Service to begin the Formulary Exception Process. Customer Service:  1-866-260-4646
  • Diabetic Meter Program – plan participants with diabetes may qualify for a free blood glucose meter when diabetic testing supplies are ordered through the mail order program.

CVS uses a formulary list of generics and preferred medications to keep your prescription copays at the lowest cost possible. Recognizing that there are times when a patient cannot take a generic, FCPS has established a Formulary Exception Process. This process requires a member take a number of generic drugs, under the direction of their physician. Should those generic drugs not be appropriate for the member’s condition, an exception for a brand drug/non-formulary drug can be approved for limited time period. If you believe this applies, you or your physician may contact CVS Customer Service to begin the Formulary Exception Process. Customer Service:  1-866-260-4646

Frequently Asked Questions

  • Prior Authorization - Some medications require Prior Authorization (PA). If this applies to a medication that you have been prescribed, CVS will notify your physician of this requirement when your prescription is received. The prescribing physician will be asked to provide additional medical information to approve the prescription for you. Once this has been provided and evaluated by CVS, the prescription will be filled or your physician will receive specific information as to why the medication was denied. You will be mailed an explanation as to the denial of the medication which will include information on the appeal process.

Prior Authorization Frequently Asked Questions

Please review the additional information on generics and other prescription resources in the links below.