Your drug coverage

Members get their drug benefits through CVS Caremark and can look up covered medicines using the online formulary and Drug Look Up tool below. Members can fill prescriptions at any in-network pharmacy. We can mail many long-term medicines to you. Members can order by mail, by calling the FastStart number (800) 875-0867, or by having your doctor send in the prescription.

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 drug list can change each year on January 1. Changes are shown on a special grid. You can find the full drug list and any annual changes 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 at (866) 472-9484.

How the drug list works

CVS Caremark provides drug benefits for your health plan. To see if your drug is covered use the drug lookup tool or view your state’s drug list.

• Your cost depends on the drug and your plan benefits.
• Your plan has a network of mail order pharmacies that can send you up to 90 days' supply of eligible medications.
• A 90-day supply may cost 3 times your one-month copay or coinsurance.
• Your plan’s network also offers 90-day fill at network retail pharmacies. You can find these locations when searching for a participating network pharmacy.
• 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, your doctor’s name and phone number and your mailing address.
2. Ask your doctor to send an electronic prescription or call (844) 826-43357 with your member ID number, date of birth and mailing address.
3. Complete and send the mail service order form.

If you need Specialty medications

Specialty medications can be drugs with limited distribution, require special handling or can only be prescribed to you if you get complex counseling or monitoring from your doctor. These medications are placed in the Specialty Tier on the drug list. To start specialty medication service, please contact the CVS Pharmacy Help Desk at (888) 407-6425 or CVSSpecialty.com.