Your prescription drug coverage will be provided through your pharmacy benefit manager. The pharmacy benefit manager could be a separate prescription drug company. Associates who enroll under Aetna,
Anthem Blue Cross, Cigna, or UnitedHealthcare will have their pharmacy benefits managed by CVS Caremark. All other carriers will manage their own prescription drug coverage.
That means your prescription drug coverage depends on the medical coverage level you choose and your medical
insurance carrier.
Your Coverage Level Matters
You pay nothing for preventive drugs, as determined by your pharmacy benefit manager. You need a doctor’s prescription, and you must use an in-network retail pharmacy or mail-order service.
Bronze
You pay the full cost for prescription drugs until you reach the annual medical deductible. Then you pay coinsurance. Once you reach the out-of-pocket maximum, you pay nothing.
Bronze Plus, Silver, Gold, or Platinum
You pay a copay for all prescription drugs. Once you reach the out-of-pocket maximum, you pay nothing.
Your specific prescription coverage is based on the medical coverage level you select. Get the details.
Your Carrier Matters
Each pharmacy benefit manager has its own rules about how prescription drugs are covered. So you need to do your homework to find out how your medications will be covered—before choosing an insurance carrier.
Get a list of prescription drug questions to ask.
You can preview the CVS pre-enrollment site to learn more about prescription coverage if you were to enroll through a national medical carrier. Click here to visit the site.
PrudentRx
As a part of the prescription plan through CVS Caremark, when you are enrolled under Aetna, Anthem Blue Cross, Cigna, or UnitedHealthcare, the PrudentRx Copay Program allows you to get all of your specialty medications at no cost to you. PrudentRx works with manufacturers to get copay card assistance for your medication (some limits and restrictions apply). Once you get started, they’ll manage enrollment and renewals on your behalf. But even if there is no copay card program available for your medication, your cost will be $0 for as long as you are enrolled in the program.
Call PrudentRx at 1.800.578.4403 for more information.