You will automatically receive prescription drug coverage through CVS Caremark when you enroll in the ChoicePlan 500 or High Deductible Health Plan (HDHP).
ChoicePlan 500 | High Deductible Health Plan* | |
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Deductible | ||
$100 per person/$200 family maximum |
Note: You must meet your combined medical/prescription drug deductible before the plan pays benefits.
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Out-of-pocket Maximum | ||
$1,500 individual/$3,000 family |
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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 |
CVS Caremark offers three ways to purchase prescription drugs:
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.
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:
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
To find out whether a pharmacy participates in the CVS Caremark network, use one of the following methods:
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.