Currently viewing Prescription Drug Coverage in Prescription

Prescription Drugs

All the national medical plan options include prescription drug coverage administered by CVS Caremark, and some HMOs administer their own prescription drug coverage. Depending on your plan, how you fill your prescription and the type of medication you use, you will either pay a copay or a portion of the cost.

Prescription Refills

Your prescriber can e-scribe, phone and/or fax in a new prescription for a 90 day supply to CVS Caremark mail order. They can phone this into CVS Caremark’s new prescription team at this phone number: 1-800-378-5697 and they can fax using this number: 1-800-378-0323. If they want to send the prescription for a 90-day supply to a CVS Retail store, they can call the store’s pharmacy number or e-scribe it in if they have this functionality.

For questions or concerns, please call toll-free at 1-866-768-4261 to speak to a Customer Care representative 24 hours a day, seven days a week.

COMPARE THE PLANS

	SureSAVER	HealthSAVER	ExclusiveCARE	PerformanceCARE (Select locations)
Deductible Employee Only Family	Part of medical deductible Part of medical deductible	Part of medical deductible Part of medical deductible	$100 (waived for generics) $300 (waived for generics)	$100 (waived for generics) $300 (waived for generics)
Out-of-Pocket Maximum Employee Only Family	Part of medical out-of-pocket maximum Part of medical out-of-pocket maximum	Part of medical out-of-pocket maximum Part of medical out-of-pocket maximum	$1,750 $1,750 per person, up to $5,250	$1,750 $1,750 per person, up to $5,250
Preventive Care	$0 no deductible	$0 no deductible	Follows plan design for other prescription drugs	Follows plan design for other prescription drugs
Generic	25% after deductible	15% after deductible	$15 ($40 mail order)	$15 ($40 mail order)
Formulary/Brand	25% after deductible	15% after deductible	25% ($25 min retail; $65 min mail order)	25% ($25 min retail; $65 min mail order)
Non-Formulary	25% after deductible	15% after deductible	40% ($40 min retail; $95 min mail order)	40% ($40 min retail; $95 min mail order)

A Note About the Prescription Drug Out-of-Pocket Maximum

Under the SureSAVER and HealthSAVER plans, the prescription drug out-of-pocket maximum includes your prescription drug copays and coinsurance. Additional charges you pay for filling a prescription with a brand-name drug when a generic equivalent is available (the cost difference) do not count toward the out-of-pocket maximum. If you meet the maximum, you will continue to be responsible for paying the cost difference for any prescription that is filled with a brand-name drug that has a generic equivalent.

PRESCRIPTION DRUG COVERAGE WITH THE SURESAVER OR HEALTHSAVER PLAN

Your prescription drug costs count toward your medical deductible and out-of-pocket maximum. Once you meet your deductible, you and Nestlé will share the cost of your prescription drugs. Remember, eligible preventive prescriptions are 100% covered even before you meet your deductible.

Locate an in-network pharmacy and check your medication cost under SureSAVER and HealthSAVER (assuming you haven’t met the deductible).

Review the complete list of covered preventive prescription drugs.

Coverage with the ExclusiveCARE or PerformanceCARE Plan

Your prescription drug deductible is separate from your medical deductible. Once you meet your deductible, you will pay either a copay or a portion of the cost.

Locate an in-network pharmacy and check your medication cost under ExclusiveCARE or PerformanceCARE (assuming you haven’t met the deductible).

Get the Rx App

Refill your prescriptions, check the cost of prescription drugs, track an order and view your order history with the CVS Caremark app. Open the App Store or Google Play on your smartphone or tablet and download the app for free today!

GET THE APP