Loyola Prescription (Rx) Plan
CVS Caremark manages your prescription benefits just like Aetna manages your medical benefits. Outpatient prescriptions (mail order and specialty) must be filled through CVS Caremark. Retail pharmacy prescriptions can be filled at most retail pharmacy locations including: CVS, Walgreens, Target, Walmart, and many more participating pharmacies.
- Please note, if you take a specialty medication you must transfer your prescription to CVS Specialty. Simply ask your doctor to send your prescription to CVS Specialty by calling 800.237.2767, e-prescribing, or faxing the request to 800.323.2445. For a list of specialty medications please visit https://www.cvsspecialty.com/wps/portal/specialty/patients/registration.
- **PrudentRx - If you are enrolled in the PPO 1 or PPO 2 plans, these plans include PrudentRx for certain specialty medications. PrudentRx is designed to lower out-of-pocket costs by facilitating enrollment in drug manufacturers discount co-pay cards / assistance programs. PPO 1 or PPO 2 participants will be contacted by CVS directly to enroll in PrudentRx at the time of their first specialty fill.
- If you enroll in PPO 3 HSA, the medical and prescription drug has a combined deductible. Certain preventive generic drugs may be covered before meeting the deductible. Review the Preventive Therapy Drug List for more information.
- Visit CVS Caremark Mail Order Information or by phone - call the number on your CVS Caremark member ID card.
- For additional information, please visit caremark.com.
Where can I find the formulary drug list?
The formulary drug list is available online: http://info.caremark.com/druglist - (formulary for January for all medications minus the specialty)
- Specialty formulary is Advanced Controlled Specialty Formulary
- PPO 3 HSA has a Generics Only Preventive Therapy Drug List
Contraception Prescription
For a list of covered contraceptives, please refer to the Women's Health Preventive Services Contraceptives Drug List.
Will I pay more for prescriptions that are not filled at a CVS Caremark retail network pharmacy?
You will generally pay more for short-term (34 days or fewer) prescriptions that are not filled at a CVS Caremark retail network pharmacy. Short-term prescriptions can be filled at a network pharmacy.
How can I save money on my prescriptions?
- Ask for generics first. Generic drugs can cost up to 80 percent less than brand-name drugs.
- Remember the preferred drug list. If a generic drug isn't available, ask your doctor to prescribe a drug on your plan's preferred drug list, if appropriate. You will pay more for a brand-name medication not on the preferred list.
- Order 90-day supplies of long-term medications to save money. Sign up for CVS Caremark Mail Service to enjoy the convenience of having your medication shipped directly to you at no additional cost.
- Fill short-term prescriptions at a network pharmacy. You will generally pay more for short-term (34 days or fewer) prescriptions that are not filled at a CVS Caremark retail network pharmacy.
Why should I consider mail order? And how do I get started?
CVS Caremark Mail Order Information:
- Two Easy Ways to Get Started
- Online – visit caremark.com/mailservice, or
- By Phone - call the number on your CVS Caremark member ID card for live help getting set up.
*Be sure to have a prescription bottle in hand; all the information needed to get started is on the label.
Why Mail Order? By utilizing the 90-day supplies mail order feature, you can find savings on medications you take regularly, such as high blood pressure or diabetes medicine.
*NOTE: CVS Caremark can provide clients with a 30-day retail supply for contraceptives.
PrudentRx
If you are enrolled in the PPO 1 or PPO 2 plans, these plans include PrudentRx for certain specialty medications. PrudentRx is designed to lower out-of-pocket costs by facilitating enrollment in drug manufacturers discount co-pay cards / assistance programs. When enrolled in PrudentRx, your out-of-pocket cost will be $0 for certain medication included on the PrudentRx Specialty Drug List . This list is updated quarterly. PPO 1 or PPO 2 participants will be contacted by CVS directly to enroll in PrudentRx at the time of their first specialty fill. You must complete any additional enrollment steps outlined by CVS to receive the $0 benefit. Please note, if you opt out, you will be responsible for the coinsurance % and only the amount you pay out-of-pocket will apply towards the deductible / out of pocket maximum.
- Formulary exclusions will supersede the PrudentRx specialty drug list. If a participant’s specialty medication is not on the PrudentRx list, then the preferred brand formulary and specialty formulary or the non-preferred brand formulary and non-specialty formulary plan design will apply.
How are contraceptives covered?
Prescriptions for contraceptives are excluded under Loyola's prescription drug coverage. However, there is a program available whereby you can obtain certain contraceptive prescriptions at no cost to you, as part of the Affordable Care Act. In order to obtain these, you will obtain a separate ID card from CVS Caremark. You must use this separate contraceptive ID card in order to obtain the prescription at no cost.
- For a list of covered contraceptives, please refer to the Women's Health Preventive Services Contraceptives Drug List.
- Contact 888.924.8738 to enroll in the Contraceptives Coverage through CVS Caremark and receive your separate ID card. The RX bin # is: 004336 and the Group # is: RX3923.
Note: Medical services for contraceptives are covered separately through Aetna. In order to obtain contraceptive medical services (contraceptive counseling services/office visits, medical procedures for contraceptive services such as contraceptive device implantation and removal, voluntary sterilization (both inpatient and outpatient), and contraceptive devices such as IUDs, implants, diaphragms, and cervical caps), you will need to request and obtain a Contraceptive Services Payment Program ID card from Aetna. Visit the Birth Control Coverage - Religious Employer Exemption section of the Health Insurance page for more information.
Diabetic Accu-Chek® Meters
Diabetic Accu-Chek® blood glucose meters offered through CVS Caremark are compatible with the formulary test strips, and they are available at no charge through the free diabetic meter program. Please see the Diabetic Meter Program flyer for additional information or learn about tools and resources to help you manage your diabetes.
What CVS Caremark preventive services are covered under the Affordable Care Act?
Affordable Care Act (PDF)
Same Day On-Demand Rx Delivery
CVS Pharmacy offers prescription delivery within hours in addition to their 1-2 day prescription delivery service available nationwide. The service, delivered by Shipt, a leading same-day delivery marketplace, is available at 6,000 CVS Pharmacy locations across the country, giving you a faster and even more convenient way to get your prescriptions.
Through CVS Pharmacy's delivery offering, the majority of CVS Pharmacy stores across the country are able to offer same-day delivery of eligible prescriptions. When a medication has been filled and is ready for pickup, you can opt to have your medication(s) delivered within hours. You simply select On-Demand prescription delivery service via the CVS Pharmacy app, through SMS text, or by calling your local CVS Pharmacy. The delivery service charge is $7.99 and the packages will be delivered by Shipt.
Along with eligible prescriptions, thousands of the most popular health and household items carried by CVS Pharmacy, including cold and flu remedies, allergy medications, pain relief, first aid, digestive health, vitamins, baby, personal and feminine care products, can be added to delivery orders.
If you don't need your prescription(s) as quickly, or if you are looking for a lower cost delivery option, you can select 1-2 day delivery for a reduced fee of $4.99.
CVS Caremark manages your prescription benefits just like Aetna manages your medical benefits. Outpatient prescriptions (mail order and specialty) must be filled through CVS Caremark. Retail pharmacy prescriptions can be filled at most retail pharmacy locations including: CVS, Walgreens, Target, Walmart, and many more participating pharmacies.
- Please note, if you take a specialty medication you must transfer your prescription to CVS Specialty. Simply ask your doctor to send your prescription to CVS Specialty by calling 800.237.2767, e-prescribing, or faxing the request to 800.323.2445. For a list of specialty medications please visit https://www.cvsspecialty.com/wps/portal/specialty/patients/registration.
- **PrudentRx - If you are enrolled in the PPO 1 or PPO 2 plans, these plans include PrudentRx for certain specialty medications. PrudentRx is designed to lower out-of-pocket costs by facilitating enrollment in drug manufacturers discount co-pay cards / assistance programs. PPO 1 or PPO 2 participants will be contacted by CVS directly to enroll in PrudentRx at the time of their first specialty fill.
- If you enroll in PPO 3 HSA, the medical and prescription drug has a combined deductible. Certain preventive generic drugs may be covered before meeting the deductible. Review the Preventive Therapy Drug List for more information.
- Visit CVS Caremark Mail Order Information or by phone - call the number on your CVS Caremark member ID card.
- For additional information, please visit caremark.com.