Caremark Prescription Drug
Active State Employees, Non State Employer Group and NON-MEDICARE ELIGIBLE Retiree/Direct Bill Members
TOLL FREE - 800-294-6324
TDD TOLL FREE - 800-863-5488
Caremark Connect Specialty Pharmacy TOLL FREE - 800-237-2767
Print Your Caremark ID Card Instructions
CVS Caremark Documents
- 2017 Caremark Benefit Description for Plan A
- 2017 Caremark Benefit Description for Plan C
- Plan A – Check Drug Cost Link
- Plan C – Check Drug Cost Link
- 2017 Caremark Preferred Drug list - Effective 01-01-17
- 2017 Formulary Exclusions Requiring Prior Authorization
- 2017 Advanced Control Specialty Preferred Drug List - Effective 01-01-17
- 2017 Caremark Injectable Drug List
- 2017 Caremark - Brand Medications Requiring Use of a Generic First - Effective 04-01-16
- 2017 Caremark Special Case Drug List
- 2017 Caremark Discount Tier Medications
- List of Oral Cancer Medications for Plan A ONLY
- Caremark Claim Reimbursement Form
- Drugs Covered under the Site of Care Program & Drug Benefit Alignment with the Medical Plan
Prescription drug coverage is provided through Caremark for Plans A and C, and its cost is included in the health plan rates. While the Preferred Drug List (PDL) is the same for both plans, the amount you pay will vary depending on the plan you select as explained below.
- Plan A. Under this plan, generally you pay a Coinsurance for your prescription drug costs throughout the year, up to a combined medical and pharmacy Out Of Pocket maximum of $5,750 for single and $11,500 for member with dependent coverage per year.
- Plan C. Until you reach your deductible, you will pay 100% of the discounted cost for your prescription drugs when you present your Caremark ID card. Once you have reached your annual health plan Deductible, you pay a Coinsurance for your prescription drug costs throughout the year, up to a combined pharmacy and medical Out Of Pocket maximum of $5,000 for single and $10,000 for family. See pages 4 and 22 - 23 for Plan C pharmacy tiers and Coinsurance.
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 available at either: www.kdheks.gov/hcf/sehp/Caremark.htm or www.caremark.com
You can also call Caremark at 800-294-6324 for help finding a preferred drug. A number of popular name brand drugs are projected to be available in generic versions during 2017. This list is also on the website.
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 to any appointments so you can discuss your options. The Caremark plan is designed to encourage you and your health care provider to choose the most cost-effective and clinically-effective medications available. Home delivery is available 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 firstname.lastname@example.org
Specialty and biotech drugs are designed for difficult conditions that don’t respond to traditional therapy. A complete list of Specialty Drugs is available at www.kdheks.gov/hcf/sehp/Caremark.htm These drugs are available only through the Caremark Connect Specialty Pharmacy. Contact Caremark Connect at 1-800-237-2767. A Caremark representative will coordinate patient care with the provider and arrange for medication delivery.