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http://www.caremark.com/pharmacy

OVERVIEW

Welcome to Caremark’s Prescription Drug Program!

Your prescription drug benefit will be administered by Caremark beginning January 1,1999. The program enables you to purchase prescription drugs at a Retail Pharmacy or through Caremark’s Mail Service Pharmacy.

AT-A-GLANCE

  RETAIL PROGRAM MAIL SERVICE PROGRAM
WHEN TO USE IT For Immediate drug needs or short-term medications For maintenance or long-term medications
YOU PAY $0.00 for each generic prescription

$6.00 brand name for each brand name prescription with no generic prescription available

Difference in cost for each brand name prescription with a generic available

$0.00 for each generic prescription

$6.00 for each brand name prescription

DAYS SUPPLY LIMIT 34-day supply 90-day supply
REFILL LIMIT No limit No limit

CAREMARK CUSTOMER SERVICE

1 -800-378-0972

How to use Your Retail Program

Your Out-of-Pocket Expense for Retail Service at a Caremark Participating Pharmacy:
bullet$0.00 for generic prescriptions, up to a 34-day supply
bullet$6.00 for brand name prescriptions when no generic available, up to a 34-day supply
bulletDifference in the cost for brand name prescriptions with a generic available, up to a 34-day supply

Using a Caremark Participating Pharmacy

1. Ask your doctor to write a prescription for up to a 34-day supply.

2. Take your prescription to a Caremark Participating Pharmacy.

3. Present your Caremark I.D. card.

4. Verify that the pharmacist has accurate information about you and your covered dependents, including date of birth and sex.

5. Pay your portion of the prescription price.

6. Sign for and receive your prescription.

Caremark’s Retail Program includes over 51,000 participating pharmacies nationwide, and more than 20,000 independent community pharmacies.

Using a Non-Participating Pharmacy

In most cases, you will not need to visit a nonparticipating pharmacy because there are over 51,000 participating pharmacies in the Caremark program. However, if you choose to go to a nonparticipating pharmacy, you will pay 100 percent of the prescription price. You will then need to submit a paper claim form, along with the original prescription receipt(s) to Caremark for reimbursement of covered expenses. This option will cost you more.

How To Use Your Mail Service Program

Your Out-of Pocket Expense for Caremark Mail Service:
bullet$0.00 for generic prescriptions, up to a 90-day supply
bullet$6.00 for brand name prescriptions, up to a 90-day supply

Caremark’s Mail Service Program provides a convenient and cost-effective way for you to order up to a 90-day supply of maintenance or long-term medication for direct delivery to your home. Follow this easy step-by-step ordering procedure.

1. For new maintenance medications, ask your doctor to write two prescriptions:

bulletone, for up to a 90-day* supply plus refills, to be ordered through the Mail Service Program.
bulletthe other, to be filled immediately at a Caremark Participating Pharmacy for use until you receive your prescription order from the Mail Service Program.

*Note: By law Caremark must fill your prescription for the exact quantity of medication prescribed by your doctor up to the 90 day plan limit.

2. Complete a Mail Service Patient Profile/Order Form and send it to Caremark, along with your original prescription(s) and the appropriate payment for each prescription. Be sure to include your original prescription, not a photocopy.

bulletYour payment is payable by check, money order or credit card. For credit card payments, simply include your Visa, Discover or MasterCard number and expiration date, in the space provided, on the Mail Service Patient Profile/Order Form.
bulletYou will receive your prescription within 14 days after Caremark receives your order.
bulletYou will receive a new Mail Service Patient Profile/Order Form and pre-addressed envelop with each shipment.

Mail Service Refills

You can receive refills on maintenance medication by phone or mail. Order three weeks in advance your current prescription running out. Suggested refill dates will be included on the prescription label you receive from Caremark.

1. Request ™ Use a touch-tone phone to call toll-free 1-800-378-0972 to order prescription refills or inquire about the status of your order. Caremark’s fully automated refill phone service available 24 hours a day. When you call, be ready to provide:
bulletYour social security number or member ID.
bulletMember’s year of birth.
bulletYour VISA, Discover or MasterCard number, with expiration date.

  1. Refill-by-Mail. Attach the refill label provided with your prescription order to a Mail Service Patient Profile/Order Form. Enclose a check c money order for the appropriate payment, or write your credit card number, with expiration date, on the order form. Mail the order form t Caremark in the pre-addressed envelope included with your previous shipment.

Commonly Asked Questions

Q How long does it take for my prescription to arrive by mail?

A You will receive your prescription within 14 days after Caremark receives your order.

Q What if I need to take my maintenance medication right away?

A Ask your doctor for two prescriptions, one for a 34-day supply and one for up to a 90-day supply. Have the 34-day supply filled immediately at a Caremark Participating Pharmacy and send the 90-day supply prescription to Caremark. 

Q How do I switch my prescription from a nonparticipating pharmacy to a Caremark Participating Pharmacy?

A Go to a Caremark Participating Pharmacy and tell the pharmacist where your prescription is currently on file. The pharmacist will contact the pharmacy and make the transfer for you.

Q How many refills can I get at a retail pharmacy?

A You can obtain as many refills as your doctor has indicated on the original prescription.

Q Can I receive additional I.D. cards?

A Additional I.D. cards can be obtained by calling your benefits office.

 

Helpful Hints

Check your prescription before leaving your doctor’s office to make sure that:

the doctor’s name is legible

the doctor’s phone number and address are on the prescription

the exact daily dosage is indicated

the exact strength is indicated

the exact quantity with number of refills is indicated

the full first name and last name of the patient are legible

 

Money Saving Tips

$ Use a Caremark Participating Pharmacy. Remember, if you use a non-participating retail pharmacy, you will pay full price for each prescription and will need to submit a claim form to Caremark. However, reimbursement for your prescriptions will depend on your specific plan coverage. 

$ Ask for generics. By law, both brand name drugs and generic drugs must meet the same

standards for safety, purity, strength and quality.

$ Remind your doctor to write "90-day supply", when clinically appropriate, for maintenance medications that are purchased through Caremark’s Mail Service Program. By law, Caremark must fill your prescription for the exact quantity of medication that your doctor prescribes, up to the 90 day plan limit.

 

Any Questions?

Call Caremark Customer Service

1-800-378-0972

Monday Friday

7:00 a.m. to 9:00 p.m., (CST)

Saturday 8:00 a.m. to 12:00 p.m., (CST)

OR

visit our website:

http://www.caremark.com/pharmacy