Prescription Coverage

The new vendor for pharmacy benefits for 2018 is CVS/Caremark.

The Indiana State Personnel Department is pleased to announce that as of January 1, 2018, CVS Caremark is the new prescription benefit manager.  If you are enrolled in medical insurance your prescription coverage will automatically transfer to CVS Caremark. Although the prescription benefit manager has changed, the prescription benefit copay and coinsurance tier design will remain the same.

What does this change mean to you?

Under CVS Caremark, you will have a large network of participating retail pharmacies to choose from. There is no requirement for you to switch to a CVS pharmacy. However, as an added benefit, 90 day supplies will now be offered both through mail service and CVS Pharmacies. For a full list of in-network pharmacies, please visit www.caremark.com in December.

One of the most substantial benefits you will see with the transition to CVS Caremark is the introduction of point-of-sale (POS) rebates to members. CVS Caremark negotiates with the drug companies to establish rebates for certain drugs. For example, a drug may have a list price of $250 with a rebate of $100. In the past, you would have been responsible for the full $250 until your deductible was met. However, with the new point-of-sale rebates, you will only be responsible for paying $150 at the time you pick up your prescription. In this example, you would save $100. Not only does POS rebates save you money, they also make prescription purchases more transparent.

The easiest way to manage your prescriptions is through CVS Caremark’s website or mobile app.  Within both platforms, you may review your mail order prescription, check drug costs and coverage, find a network pharmacy and keep track of your prescription spending. You may also transfer a current prescription or submit a new one by simply submitting a picture of the prescription label or written prescription. For additional ease, you can even enroll in automated refills. To get started, all you need to do is register at Caremark.com and download the CVS Caremark mobile app beginning in December.

CVS Caremark and INSPD are working hard to make this transition as smooth as possible. As part of the change, CVS Caremark is collaborating with Express Scripts to transfer your existing prescription(s) so you will not need a new prescription(s) from your doctor. Notifications will be sent in early November to anyone who has a prescription that cannot be transferred along with any prescriptions that will no longer be covered or will be switching prescription tiers.

Below is a quick look at the 2018 prescription coverage.

If you have any questions about how this change will impact you, please feel free to contact the Benefits Hotline at 317-232-1167 or toll free at 877-248-0007 (if outside of Indianapolis).

Check Prescription Drug Costs

Find out if your medication is covered and what your estimated cost will be based on your medical benefit plan you elect. This tool from CVS Caremark shows you lower-cost options, if available. Price varies by location.

Prescription Coverage Quick Links