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CVS Caremark Prescription Drug Program Update

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Effective Jan. 1, 2012, CVS Caremark became the new prescription drug program for benefits-eligible employees. Two membership cards per subscriber were mailed to the employee’s home address in mid-December. While both cards bear the subscribers name, all insured dependents can use them. Cards must be presented at the pharmacy to fill a prescription.

You do not need to use a CVS pharmacy.

If you did not receive your cards, you can still fill prescriptions while waiting to receive replacements by asking the pharmacy to contact Caremark to verify eligibility. To request new cards, call Caremark customer service at 866-768-4252.

By registering your card on the CVS Caremark website https://www.caremark.com/wps/portal  you can order or transfer prescriptions, check an order status, sign up for the mail order program, and email a pharmacist.

There is no co-pay for diabetic supplies; employees who paid one in 2012 will be reimbursed. Caremark has made the appropriate changes to see that no co-pay for diabetic supplies is charged in the future. 

Caremark also has updated its system to reflect prescription approvals received from Harvard Pilgrim. However, there may be situations in which the prior approval was not obtained or the prescription has expired, making a physician’s authorization necessary. If that is the case, your physician’s office needs to call Caremark’s prior authorization department at 800-626-3046. Authorization is required annually.

Use of generic drugs continues to be encouraged as generics can represent a significant cost savings for both the employee and employer. If a generic is available, replacing it with the brand name drug requires the medical provider to indicate on the prescription “dispense as written” before the brand name prescription can be established. In some cases, prior authorization for the brand name drug may be required. If you are having trouble with the process, contact Human Resources.

A list of frequently asked questions is posted at http://www.usnh.edu/hr/pdf/2012Final_CareMark_Prescription_Drug_Plan_FAQ.pdf.

To appeal a denied prescription, you or your physician can send a letter of appeal to:

CVS Caremark
Appeals Department
MC109
P.O. Box 52084
Phoenix, AZ 85072-2084
Fax Number:  1-866-689-3092

For more information or assistance, contact HR benefits representatives Kristie Camacho 2-0509 or Sue Nolan 2-0504.