Your drug coverage

Your drug list, also called a formulary, is the list of medicines covered by your plan. Use the drug look up tool below to search by name and see any notes, like if a drug needs approval or has limits.

Covered drugs are grouped by cost tiers. Generic drugs usually cost less than brand or specialty drugs. Your copay or coinsurance depends on the tier.

The formulary can change each year. Updates start on January 1 and are shown on the formulary changes grid. You can also find the full drug formulary on the forms and documents page.

Prescriptions are covered at in-network pharmacies. Out-of-network coverage may be limited to emergencies or urgent needs. If you have trouble at the pharmacy, please do not pay for the prescription. Contact us for help.

CVS Caremark provides drug benefits for your plan. To see if your drug is covered, use the drug look up tool below or view your state’s drug formulary.

Please keep in mind:

• Your cost depends on the drug and your plan benefits.
• Your plan has a network of pharmacies that can process and dispense up to 90 days' supply of eligible medications through mail order.
• A 90-day supply may cost three times your one-month copay or coinsurance.
• Your plan’s network also offers 90-day fill at network retail pharmacies. If you are looking for retail pharmacies that participate in the 90-day fill at retail program, participating pharmacies will show “90-day Supply Available” in the details of your search results.
• Outside your service area, drugs are covered for emergencies only.

To start mail-order service, here’s what you need to do:

1. Call CVS Caremark FastStart at (800) 875-0867 and provide your member ID number, prescription name, doctor’s name and phone number, and your mailing address.
2. Ask your doctor to send an electronic prescription or call (800) 378-5697 with your member ID number, date of birth and mailing address.
3. Complete and send the mail service order form. 

Specialty medications

Specialty medicines need extra care. Some need special storage, counseling, or check‑ins. Others are only available from certain pharmacies. These drugs are in the Specialty tier on the drug list. To start your specialty medicine service, please contact the CVS Pharmacy Help Desk at (888) 407-6425 or visit CVSSpecialty.com.

Your plan’s network also has a specialty pharmacy that is not connected to the Pharmacy Benefit Manager, Publix Specialty Pharmacy.