• Prescriptions are filled with generic drugs, if available
• If a generic drug is available and you choose a brand name (or your at provider prescribes one), you must pay the difference in cost between the brand name and the generic – up to a maximum of $75 for retail (for a 30-day supply) and $187.50 for a 90-day supply – plus the cost for the brand

• If your provider prescribes a brand-name medication that has a generic alternative, you must try a generic alternative for at least one month
• At the end of the month, you can remain on the generic medication or switch to the brand name
• If you don’t try the generic alternative and you continue to take the brand-name drug, you will be required to pay the full cost of the brand-name drug
• You may need to repeat this process (trying a generic for at least one month) every two years
• If your provider believes you should take a brand-name drug instead of a generic, he/she can request an exception by calling 877.203.0003. The provider will need to provide your name, CVS/caremark member ID (found on your prescription drug card) and your date of birth.
• CVS/caremark will review each request independently and base its approval on the medical necessity of the brand-name medication. Your provider may have to resubmit this request every two years

• All prescriptions for maintenance medications (for chronic, long-term conditions, such as high blood pressure, high cholesterol, diabetes, etc.) must be filled as a 90-day supply
• You may get a 90-day supply at a CVS pharmacy or through mail order
• Whether you choose delivery by mail or pick-up at a CVS pharmacy, you’ll pay the lower cost
• You’ll be notified by CVS/Caremark if you fill prescriptions for medications that fall under this program
• Switching your prescription to Maintenance Choice is easy
  • Log into your account at caremark.com
  • Call 800.503.3241

• If you live within 50 miles of a CVS pharmacy, CVS will ship a 90-day supply of maintenance medications, short-term antibiotics, and medical supplies directly to your home within 1-2 days for a small charge
• If you live within 10 miles of a CVS pharmacy, your order can be delivered within four hours for a small charge
• Contact your local pharmacy for details
• Note: Not currently available at Manhattan, New York and Puerto Rico stores, as well as Navarro pharmacies in South Florida

• Dispensed exclusively through CVS/caremark’s specialty pharmacy
• Mail your prescriptions to the specialty pharmacy or have your prescribing physician send them electronically
• As an added convenience, you may drop off and pick up your specialty drug prescriptions at a local CVS pharmacy

PrudentRx Program

PrudentRx is a program only available through the Signature Plan to help make specialty drugs* more affordable for you. If a medication you take is eligible for the program, PrudentRx will reach out to you directly to enroll. Enrolled members pay $0 out-of-pocket for most CVS/Caremark specialty medications.

*Specialty drugs are drugs derived from living cells that are normally injectable or infused. They are used to treat complex or chronic conditions such as cancer, rheumatoid arthritis, hemophilia, H.I.V. psoriasis, inflammatory bowel disease and hepatitis C.

• Many prescriptions are available at no cost to you, like bupropion (Zyban) and varenicline (Chantix)
• Plan covers all over-the-counter (OTC) products and prescription drugs related to smoking cessation at no cost (limited to two 12-week cycles each calendar year)
  • Your provider can give you, or call in, a prescription for an OTC tobacco cessation product so you pay nothing for the product
  • Or you can pay the full cost of the item at the store and submit claim to CVS/caremark for reimbursement