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Prescription Drugs

You will automatically receive prescription drug coverage through CVS Caremark when you enroll in the ChoicePlan 500 or High Deductible Health Plan (HDHP).

Benefits-at-a-glance

  ChoicePlan 500 High Deductible Health Plan*
Deductible
$100 per person/$200 family maximum
  • $1,800 individual/$3,600 family for in-network
  • $2,800 individual/$5,600 for out-of-network
 
Note: You must meet your combined medical/prescription drug deductible before the plan pays benefits.
Out-of-pocket Maximum
$1,500 individual/$3,000 family
  • $5,000 individual / $10,000 family ($6,850 per individual) for in-network
  • $7,500 out-of-network / $15,000 ($15,000 per individual) for out-of-network
Copay/coinsurance — In-network retail pharmacy
Generic drug** $10
Preferred brand-name drug*** $30
Non-preferred brand-name drug 50% of the cost of the drug, with a minimum payment of $50, to a maximum of $150
Copay/coinsurance — Mail Service program or Maintenance Choice program
Generic drug** $20
Preferred brand-name drug*** $75
Non-preferred brand-name drug 50% of the cost of the drug, with a minimum payment of $125, to a maximum of $375
Copay/coinsurance — Specialty
Generic drug** $20
Preferred brand-name drug*** 25% of the cost of the drug, with a minimum payment of $50, to a maximum of $150
Non-preferred brand-name drug 50% of the cost of the drug, with a minimum payment of $100, to a maximum of $250
*In the High Deductible Health Plan (HDHP), you must meet your combined medical/prescription drug deductible before the Program will pay benefits, except for certain preventive drugs.
**The use of generic prescription drug equivalents whenever possible (through both the retail and CVS Caremark Mail Service programs) is more cost-effective. Ask your medical professional about this distinction. If you or your doctor requests a brand-name drug and a generic alternative is available, you will pay the difference between the cost of the brand-name drug and the generic drug in addition to the copay for the generic drug.
***Citi does not determine preferred brand-name drugs. Rather, CVS Caremark brings together an independent group of practicing physicians and pharmacists who meet quarterly to review the preferred brand-name formulary list and make determinations based on current clinical information. Call CVS Caremark Customer Care at 1 (844) 214-6601 or visit www.caremark.com for a copy of its Preferred Formulary (updated at least quarterly). Note: Preferred brand-name prescription drugs count toward the out-of-pocket maximum.
 

CVS Caremark offers three ways to purchase prescription drugs:

iconPickup at a CVS Pharmacy

You can pick up your short-term prescriptions or a 90-day supply at CVS retail stores, including those within a Target retail store. If you choose to pick up your prescription at a CVS Pharmacy or retail store, it will not cost more than using the CVS Caremark Mail Service or Maintenance Choice program. Note: If you go to an out-of-network pharmacy, you will pay the full cost yourself, and then you can file a claim to be reimbursed at the contracted rate, after you meet your deductible and pay the applicable copay. You will not pay more. If you are in-network, there is no initial out of pocket payment.

iconMail Service or the Maintenance Choice Program

You may save money by having your maintenance and preventive drugs (up to a 90-day supply, plus refills if appropriate) either delivered by mail or picked up at a CVS pharmacy store through the CVS Caremark Mail Service or Maintenance Choice® program.

 

Start filling your 90-day prescriptions through CVS Caremark:
  1. By phone – Call CVS Caremark Customer Care at 1 (844) 214-6601.
  2. By mail – Fill out and return a Mail Service order form. You can download one from CVS Caremark, or request one from CVS Caremark Customer Care.
  3. Online – Visit www.caremark.com/faststart and log in. You may then request a new Mail Service prescription from your doctor using “Request a Prescription with Fast Start.” You may also order and track your refills via the CVS Caremark mobile app.
iconSpecialty Pharmacy

The CVS Caremark Specialty Pharmacy dispenses oral and injectable specialty medications for the treatment of complex chronic diseases, including, but not limited to, multiple sclerosis, hemophilia, cancer and rheumatoid arthritis. Specialty medications purchased through the CVS Specialty Pharmacy are limited to a 31-day supply or less. It's important to know that prescriptions for specialty medications take longer to fill than traditional medications due to added steps and approvals.

You can fill your first two specialty drug prescriptions at a retail pharmacy or through the CVS Specialty Pharmacy. For refill three or more, you must use the CVS Specialty Pharmacy with the exception of HIV and transplant drugs which can be filled at a retail pharmacy. Once you are using the program, the CVS Specialty Pharmacy will call your physician to obtain a prescription and then call you to schedule delivery.

To learn more about CVS Caremark’s Specialty Pharmacy services, including the cost of your prescription drugs, call 1 (844) 214-6601.

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Find a Network Pharmacy

To find out whether a pharmacy participates in the CVS Caremark network, use one of the following methods:

  • Ask your pharmacist.
  • Visit www.caremark.com.
  • Download the CVS Caremark free mobile app from your device’s app store (search for “CVS Caremark”).
  • Call CVS Caremark Customer Care at 1 (844) 214-6601.

 

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Location Options for Drug Infusions

If you’re enrolled in a Citi medical coverage and you receive certain specialty drugs at an outpatient hospital facility, you may receive a letter from Citi about utilizing a different site of care for infusions. This would include receiving infusions for those drugs in an office setting, an infusion center or in the comfort of your own home.