Prescription Drug Coverage

Caremark Prescription Drug Plan

Prescription drug coverage is provided through Caremark for Plans A, B and C, and its cost is included in the health plan rates. While the Preferred Drug List (PDL) is the same for all plans, the amount you pay will vary depending on the plan you select as explained below.

• Plan A and Plan B
  Under these plans, generally you pay a coinsurance for your prescription drug costs throughout the year, up to a combined coinsurance maximum of $2,580 per person per year.
• Plan C
  Until you reach the deductible, you will pay 100% of the discounted cost for your prescriptions when you present your Caremark ID card. Once you have reached your annual health plan deductible, you will pay coinsurance for your prescription drugs. Remember, you can use the funds in your HSA to help pay for these costs. There is a chart with more details in the benefits comparison insert to your Open Enrollment materials. The generic incentive program is still included within the Plan C prescription drug coverage. If you use a brand name drug instead of its generic equivalent, you will pay your coinsurance plus the difference in the cost between the generic and the brand name drug.

Before talking to your physician about prescriptions, it is suggested that you print out the Preferred Drug List (PDL) from the website and take it with you so you can talk to your doctor about your options. If the physician says you must take a brand name drug, ask if there is a preferred brand name drug listed on Caremark’s PDL that you can take. This PDL is updated quarterly so please check for updates throughout the year. Regardless of which plan you elect, your out-of-pocket costs will be lower if you use generic and/or preferred brand name drugs. The PDL is also available at www2.caremark.com/kse or yYou can call Caremark at 800-294-6324. A number of popular name brand drugs are projected to be available in generic versions during 2012.

The Caremark plan is designed to encourage you and your health care provider to choose the most cost-effective and clinically-effective medications available. Plans A and B allow up to a 60-day supply for home delivery through Caremark and reorders are processed in as little as five to seven days. To place an initial order or reorder by phone, call 1-800-294-6324 or e-mail online@caremark.com

Specialty and biotech drugs designed for difficult conditions that don’t respond to traditional therapy, and are available only at Caremark Connect Specialty Pharmacy. Contact Caremark Connect at 1-800-237-2767 and a representative will coordinate patient care with the provider and arrange overnight shipping.