Prescriptions

Your prescription drug benefit is available when you need prescriptions filled. You can visit more than 68,000 retail pharmacies nationwide to fill your prescriptions. You also have access to clinical pharmacists for information and support.

Prescription Drug Tiers

Non-HDHP Plan Prescription Benefits

HDHP Plan Prescription Benefits

Controlling Your Prescription Copay

To get the most from your benefits plan, it pays to be a wise consumer. In many cases, you can control how much your share of costs will be when you fill a prescription. How? Generic drugs cost less to manufacture and they’re just as effective as the name brands. You’ll save money when you request them because generics have a lower copay than preferred or non-preferred drugs.

*Please note: If you purchase a brand-name drug while a generic is available, you will be charged the brand-name copay PLUS the cost difference between the generic and the brand-name drug.

CVS Caremark Online

Whether you are most comfortable using your desktop, the mobile app on your smart phone, your laptop or your iPad, CVS Caremark can help you digitally manage your prescription benefits when you visit www.caremark.com:

• Check Drug Cost and Coverage
• Get Started with Delivery by Mail
• Easy Refills
• Manage Your Profile
• View ID Card
• Pharmacy Locator
• Find Opportunities to Save

The Performance Drug List (CVS)

Also called a formulary, the Performance Drug List is created by pharmacy experts and lists FDA-approved, safe, effective and economical drugs.

How the Performance Drug List works:

• Drugs are added to the list on a quarterly basis.
• Brand-name drugs can be removed at the end of the calendar year.
• Every January, the list is updated and available.
• If a generic becomes available, the brand-name drug will become a non-preferred drug, and may only be available for a higher copay.
• When a generic drug becomes available, you’ll pay the lowest copay if you choose the generic.

Why Generics Make Sense

Consider all of the compelling reasons to protect your pocketbook with the lower-price generic drugs:

• Generics can cost up to 75 percent less than their brand-name equivalents.
• FDA testing is exactly the same for generic and brand-name drugs.
• Generics contain the same active ingredients as the original, brand-name drug, in the same amounts and dosages.
• Generic drugs sometimes look different from the original brand-name drug in color or shape, but only because they may have different inactive ingredients that won’t change how the drug works.
• Nearly half of all brand-name drugs have generic equivalents—but you may have to ask for them.
• Generics have the lowest copay under this plan, so you save on every prescription.

Maintenance Drugs

In order to receive a three-month supply of maintenance prescriptions for just two copays you must choose to utilize the CVS Caremark mail order program or visit a CVS pharmacy retail location. If you choose to use any other retail pharmacy, you will only be permitted to fill your prescription for a 30 day supply and will not receive the additional copay savings. To enroll in the mail order program, call CVS Caremark at 866-475-7589 or go online at www.caremark.com.

Specialty Pharmacy

Specialty medications are unique and require extra attention and support. We have partnered with CVS Specialty Pharmacy to provide all ASBAIT members with a highly coordinated, efficient and flexible pharmacy solution for specialty medications.

CVS Specialty Pharmacy is the specialty pharmacy for all members of ASBAIT, whether you use the Banner Network or Aetna Choice POS ll. It’s a different kind of pharmacy. It does much more than just provide your medication; it also helps you manage your condition, as well as your health.

With CVS Specialty Pharmacy, you’ll get the support of a dedicated care team led by pharmacists and nurses specially trained in your condition. You’ll also have the choice to have your medications delivered anywhere nationwide or pick them up at any CVS Pharmacy® location. And they’ll help you with insurance, handle your claims and find ways to keep your out-of-pocket costs low, too. Visit www.CVSspecialty.com to learn more.

If you take a specialty medication, don’t hesitate to reach out to CVS Specialty Pharmacy at 800-237-2767 if you have any questions.

Specialty Medications Savings

The PrudentRx Program helps make it possible to get specialty medications at no out-of-pocket cost. The program works when you fill prescriptions at CVS Specialty Pharmacies on any covered specialty medication(s) on the plan’s designated drug list, which can be obtained by calling 800-578-4403 (Monday-Friday 8:00 AM-8:00 PM, ET) or located using http://www.prudentrx.com.

This program is available for all ASBAIT medical plans.

• You’ll need to call the PrudentRx member advocates line to ensure proper registration and receive available copay cards.
• If you choose to opt out of this program, you’ll be responsible for a 30 percent coinsurance payment on any medication currently eligible under the PrudentRx program.
• If you need help applying for a copay card, please contact the PrudentRx member advocate team at the number listed above.
• If you’re enrolled in an HDHP plan and opt into PrudentRx, you will have to meet your plan’s deductible prior to experiencing $0 out of pocket costs.

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