Your drug coverage

Your drug formulary is the list of medicines covered by your plan. Use the drug search 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 formulary can change each year. Updates start on January 1. They are shown on the drug formulary changes grid. Here’s a link to the drug formulary.

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 health plan. To see if your drug is covered, use the On Page Location Selector. Select your plan to look up covered drugs. Or view your state’s drug formulary.

Members may have prescriptions filled at any in-network pharmacy.

• Your cost depends on the drug and your plan benefits.
• Your plan has a network of mail order pharmacies that can process and dispense 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. If you are looking for retail pharmacies that participate in the 90-day fill at retail program, these 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, your 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

If you need Specialty medications

Specialty medications require special handling, complex counseling or monitoring, limited distribution, or other specialty pharmacy requirements. Specialty 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 visit CVSSpecialty.com.