CVS CAREMARK MMO PLANS
Your Personal Prescription Benefit Program
Welcome to your new prescription benefit plan, managed by CVS Caremark. Your plan is designed to bring you quality pharmacy care that can help you save money.
Following is a brief summary of your prescription benefits. The MMO PPO/HSA plan covers drugs subject to the deductible and coinsurance. However, drugs for preventive therapy are not subject to the deductible.
CVS Caremark also provides a Performance Drug List of preferred brand-name medicines that are clinically appropriate and cost-effective. Ask your doctor to consider prescribing, when medically appropriate, a preferred medicine from this list.
You will find details about Maintenance Choice®, which offers two ways for you to save on your long-term medications. CVS Caremark and the Catholic Diocese Cleveland are confident you will find value with your new prescription benefit program.
| Network Retail Pharmacy | CVS/pharmacy | Mail Service Pharmacy | |
| When to Use Your Benefit: | For immediate and short-term medication needs | For immediate and long-term* medication needs | For long-term medication needs |
| Where: | The CVS Caremark Retail Program includes more than 64,000 participating pharmacies nationwide, including independent pharmacies and chain pharmacies. To locate a CVS Caremark participating retail network pharmacy in your area, simply click on "Find a Pharmacy" at www.caremark.com or call toll-free at 1-888-607-4287. | You have the convenience of getting your long-term medications, for a 90-day supply, at one of our 6,900 CVS/pharmacy locations for your mail service copay. You also have the convenience of getting your 30-day prescriptions at your local CVS/pharmacy. To locate a CVS/pharmacy in your area, click on "Find a Pharmacy" at Caremark.com. | Simply mail your original prescription and the mail service order form to CVS Caremark. Your medications will be sent directly to your home, office or a location of your choice. |
| Copay** up to a 30-Day Supply | • $10 for each generic medication • 20% ($25 min, $75 max) for each brand-name medication on the drug list • 40% ($40 min, $150 max) for each brand-name medication not on the drug list | • $10 for each generic medication • 20% ($25 min, $75 max) for each brand-name medication on the drug list • 40% ($40 min, $150 max) for each brand-name medication not on the drug list | Up to a 90-day supply • $25 for each generic medication • 20% ($60 min, $150 max) for each brand-name medication on the drug list • 40% ($90 min, $300 max) for each brand-name medication not on the drug list |
| Refill Limit: | One initial fill plus two refills for long-term medications | None | |
| 90-Day Supply: | Not Available | • $25 for each generic medication • 20% ($60 min, $150 max) for each brand-name medication on the drug list • 40% ($90 min, $300 max) for each brand-name medication not on the drug list | |
| Web Services: | Register at Caremark.com to access tools that can help you save money and manage your prescriptions. To register, have your Prescription Card ready. | ||
| Customer Care: | Visit Caremark.com or call toll-free at 1-844-431-4882 |
When a generic is available, but the pharmacy dispenses the brand-name medication for any reason, you will pay the difference between the brand-name medication and the generic plus the brand copayment.
*A long-term medication is taken regularly for chronic conditions or long-term therapy. A few examples include medications for managing high blood pressure, asthma, diabetes, or high cholesterol.
**Copayment, copay or coinsurance means the amount a plan member is required to pay for a prescription in accordance with a Plan, which may be a deductible, a percentage of the prescription price, a fixed amount or other charge, with the balance, if any, paid by a Plan.
