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Benefits Administration

Pharmacy Benefits

Pharmacy Benefits Manager
CVS Caremark is the pharmacy benefits manager for all plan members regardless of which healthcare option you are in.

Summary of Prescription Drug Benefits
The state's prescription drug plans require a copay or coinsurance. How much you pay depends on how the prescription is filled.

• Members pay the lowest amount for a generic (tier one) drug. A generic medicine is FDA approved and dual to the brand name product in safety, effectiveness, quality and performance.
• Members pay a higher amount for a preferred brand (tier two) drug. Preferred brands are included on the drug list.
• Members pay the highest amount for a non-preferred brand (tier three) drug. These belong to the most expensive group of drugs. These drugs are not included on the drug list.

Coordination of Benefits — Other Coverage
Click here to find out how to request reimbursement for prescriptions if you have secondary coverage with the state group insurance program.

Flu and Pneumococcal Vaccine Coverage
View the 2012-2013 flu and pneumococcal vaccine coverage information sheet on how to access this free benefit.

Tobacco Quit Aids
View this informational flier for information about free tobacco quit aids.

Maintenance Drugs
Copays are lower for certain medications from the special, less costly 90-day network. Diabetic medications and supplies are no longer provided free of cost. However, the plans made changes to the pharmacy benefit on certain drug classes for members who choose to use the mail order benefit or a 90-day network retail pharmacy. As an incentive to use pharmacies that cost the plan less, there are lower copays on a large group of maintenance drugs. For diabetics, the cost of some medications may have gone up compared to what you were paying previously. However, the cost of other drugs you are taking probably went down depending on your particular situation. This applies to certain drugs used to treat high blood pressure or cholesterol. View the maintenance drug list, visit www.caremark.com or call CVS Caremark to determine if your medication is on the list.