Prescription Drug

Last Updated February 18, 2022

Medical & Prescription Drug Benefits (08:58)

Coverage for prescription drugs is included with your medical option.

Overview

All six National Medical Program options include prescription drug coverage through CVS Caremark. (If you elect a regional medical option, prescription drug coverage is provided through the medical vendor — not CVS Caremark. If you have questions about prescription drug coverage, please contact the applicable medical vendor.)

Prescription Drug Options

Generic
Brand Formulary
Brand Non-Formulary
Specialty
HSA AdvantagePrescription Drug Copay AdvantagePrescription Drug
Generic

Retail & Mail Order:
20% after deductible

Generic

Retail:
20% ($10 min/$40 max);
no deductibleMail Order:
20% ($25 min/$100 max);

Brand Formulary

Retail & Mail Order:
30% after deductible

Brand Formulary

Retail:
30% ($40 min/$75 max);
no deductibleMail Order:
30% ($100 min/$185 max);

Brand Non-Formulary

Retail & Mail Order:
40% after deductible

Brand Non-Formulary

Retail:
40% ($55 min/$125 max);
no deductibleMail Order:
40% ($140 min/$315 max);

Specialty

Retail & Mail Order:
40% after deductible

Specialty

Retail:
If not covered by PrudenRx:
$150; no deductible iIf covered by PrudentRX:
30%; no deductible iMail Order:
More than 30-day supply not allowed

HSA SelectPrescription Drug Copay SelectPrescription Drug
Generic
Generic
Retail & Mail Order:
20% after deductible
Retail:
20% ($10 min/$45 max);
no deductible

Mail Order:
20% ($25 min/$115 max);
no deductible

Brand Formulary
Brand Formulary
Retail & Mail Order:
40% after deductible
Retail:
40% ($40 min/$100 max);
no deductible

Mail Order:
40% ($40 min/$250 max);
no deductible

Brand Non-Formulary
Brand Non-Formulary
Retail & Mail Order:
50% after deductible
Retail:
50% ($75 min/$150 max);
no deductible

Mail Order:
50% ($185 min/$375 max);
no deductible

Specialty
Specialty
Retail & Mail Order:
50% after deductible
Retail:
If not covered by PrudenRx:
$210; no deductible i

If covered by PrudentRX:
30%; no deductible i

Mail Order:
More than 30-day supply not allowed

HSA ValuePrescription Drug Copay ValuePrescription Drug
Generic
Generic
Retail & Mail Order:
25% after deductible
Retail:
20% ($10 min/$45 max);
no deductible

Mail Order:
20% ($25 min/$115 max);
no deductible

Brand Formulary
Brand Formulary
Retail & Mail Order:
40% after deductible
Retail:
40% ($40 min/$100 max);
no deductible

Mail Order:
40% ($40 min/$250 max);
no deductible

Brand Non-Formulary
Brand Non-Formulary
Retail & Mail Order:
50% after deductible
Retail:
50% ($75 min/$150 max);
no deductible

Mail Order:
50% ($185 min/$375 max);
no deductible

Specialty
Specialty
Retail & Mail Order:
50% after deductible
Retail:
If not covered by PrudenRx:
$210; no deductible i

If covered by PrudentRX:
30%; no deductible i

Mail Order:
More than 30-day supply not allowed

What You Need to Know

  • You don’t have to fill your prescription at CVS. Find local pharmacies in your network by registering online or by downloading the CVS/caremark app to access the pharmacy search tool.
  • Generic cholesterol and blood pressure medications, as well as diabetes supplies and insulin listed on the CVS formulary, are 100% covered.
  • You must use the CVS Caremark Maintenance Choice Program or Mail Order Services to fill your maintenance medication prescriptions. Maintenance medications are those you take daily for a prolonged period (e.g., blood pressure and cholesterol medications).
  • If you’re enrolled in one of the Copay medical options (Copay Value, Copay Select or Copay Advantage), you are automatically enrolled in the PrudentRx Copay Program for specialty medications as part of your prescription drug coverage through CVS Caremark.

Save Money on Your Prescription Medications

You can save money on your medications when you use Rx Savings Solutions, a confidential online tool that searches for lower-cost options for your prescribed medications.

Access CVS Caremark

You can access CVS Caremark services anytime and anywhere online or through the CVS/caremark app to:

  • Find ways to save money
  • Get new prescriptions and refills
  • Compare prescription costs
  • Find local pharmacies in your network
  • View an updated drug formulary
  • Monitor your pharmacy spending
  • Stay on track with medication reminders
  • Understand your prescription drug benefits