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Prescription Coverage

All three of the medical plans have prescription coverage through CVS Caremark. The three medical plans have the same copay/coinsurance amounts and a large network of pharmacies. For a full list of in-network pharmacies, please visit www.caremark.com.

Through CVS Caremark, point-of-sale (POS) rebates will be given to members. CVS Caremark negotiates with the drug companies to establish rebates for certain drugs. For example, a drug may have a list price of $250 with a rebate of $100. In the past, an employee would have been responsible for the full $250 until their deductible was met. However, with the point-of-sale rebates, an employee will only be responsible for paying $150 at the time they pick up their prescription. In this example, the employee would save $100. Not only do POS rebates save employees money, they also make prescription purchases more transparent.

The easiest way to manage your prescriptions is through CVS Caremark’s website or mobile app. Within both platforms, you may review your mail order prescription, check drug costs and coverage, find a network pharmacy and keep track of your prescription spending. You may also transfer a current prescription or submit a new one by simply submitting a picture of the prescription label or written prescription. For additional ease, you can even enroll in automated refills. To get started, all you need to do is register at www.caremark.com or download the CVS Caremark mobile app.

Below is a quick look at the 2022 prescription coverage.

 Prescription Drug Coverage
Deductible must be met before coinsurance rates apply
Retail Pharmacy Network
(Up to 30 day supply)
Mail Service Pharmacy
(Up to 90 day supply)
Retail Pharmacy Network
(Up to 90 day supply)
Preventive Medicines
(mandated by the ACA)
$0
(no deductible)
$0
(no deductible)
$0
(no deductible)
Generic Medicines $10 copay $20 copay $30 copay
Preferred Brand-Name Medicines 20%
Min. $30, Max. $50
20%
Min. $60, Max. $100
20%
Min. $90, Max. $150
Non-Preferred Brand-Name Medicines 40%
Min. $50, Max. $70
40%
Min. $100, Max. $140
40%
Min. $150, Max. $210
Specialty Medicines 40%
Min. $75, Max. $150 (30 day supply)

If you have any questions about how this change will impact you, please feel free to contact the Benefits Hotline at 317-232-1167 or toll free at 877-248-0007 (if outside of Indianapolis).