Pharmacy Insurance
CVS Caremark is the pharmacy benefits manager for all plan members, regardless of which healthcare option you select. CVS Caremark will mail welcome packets and prescription cards to all members. You must carry this (pharmacy) card in addition to your current (medical) ID card. If you have questions or have not received your pharmacy cards, please contact CVS Caremark customer service at 1-877-522-TNRX (8679) or visit info.caremark.com/stateoftn.
A Summary of Your Prescription Drug Benefits
- Generic (tier one) drug: You'll pay the lowest amount for a generic (Tier One) drug. A generic medicine is FDA approved and equal to the brand name product in safety, effectiveness, quality and performance.
- Preferred brand (tier two) drug: You'll pay a higher amount. Many popular and highly used preferred brands are included on the preferred drug list (PDL).
- Non-preferred brand (tier three) drug: You'll pay the highest amount. These belong to the most expensive group of drugs. These drugs are not included on the PDL.
Under the maintenance medication benefit, you can get a 90-day supply of certain drugs from a Retail-90 or mail-order pharmacy at a reduced cost. If you fill a 30-day supply, your regular copayment or coinsurance applies and for Consumer-driven Health Plan members, the deductible is not bypassed.
The maintenance medication benefit applies to drugs in the following classes: coronary artery disease, congestive heart failure, hypertension, diabetes, asthma/COPD, depression, statins used for high cholesterol and osteoporosis.
You will pay a reduced copay or coinsurance for certain medications in these classes if you fill them in a 90-day supply through either mail order OR at one of the participating Retail-90 pharmacies found here: https://www.caremark.com/portal/asset/Mail_Retail_Network_Listing.pdf.
Eligible members can receive these medications in-network at zero cost share. These medications are primarily used to treat high cholesterol. No high-dose or brand name statins are included. Applies to members ages 40 through 75 years old.
The only covered meters, test strips and supplies are those from OneTouch and Accu-Chek. The only covered needles and syringes are BD brand products. Members will have lower copays using supplies from these preferred brands.
Enrolled members with diabetes may be eligible for a new OneTouch or Accu-Chek blood glucose meter at no charge from the manufacturer. For more information on how to get a free blood glucose meter, call 877.418.4746.
Learn more about Flu, Pneumococcal, RSV and Covid Vaccine Coverage.
Members who want to stop using tobacco can get free tobacco quit aids.
- Log onto caremark.com (or register if have not already done so)
- Click on “Plan & Benefits”
- Click on the submenu “Print Member ID Card”
- Choose either
- the red button “Print Member ID Card” or
- the carrot “Request a new Member ID card” and fill in the information needed
- Click “Submit”
Quick Links
- CVS Member Handbook
- Preferred Drug List
- Specialty Drug List
- Prior Authorization: Steo Therapy, & Quantity Limit List
- Advanced Control Speciality Formulary
- 90-Day Retail Pharmacy List
- Specialty Pharmacy List
- Claim Reimbursement Form
- Locate a Network Pharmacy
- Mail Service Order Form
- Frequently Asked Questions