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CVS Caremark Maintenance Choice

Maintenance drugs are prescriptions commonly used to treat conditions that are considered chronic or long-term. These conditions usually require regular, daily use of medicines. Examples of maintenance drugs are those used to treat high blood pressure, heart disease, asthma and diabetes.

 

CVS Caremark Maintenance Medication Drug list

 

What to do next

In 2020, you may have received your maintenance medication through ESI's mail order program or pick up maintenance medication at the Smart90 Walgreens Network.

This is changing in 2021. With CVS Caremark, the process is very similar except that you will a receive mail order from CVS Caremark and you will be able to pick up your maintenance medication at a pharmacy within CVS Caremark's network.

Existing mail service refills:

CVS Caremark transferred your existing mail service and specialty refills starting the first week of January 2021.  

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  • What you need to do: If you want delivery by mail, but your prescription does not have any remaining refills, is a controlled substance, or is a covered compound medication, contact your doctor to write a new prescription for up to a 90-day supply. You will be able to submit these prescriptions for delivery by mail starting now.

 

Existing Prior Authorizations:

CVS Caremark transferred your existing prior authorizations starting the first week of January 2021.  

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  • What you need to do:  To avoid any disruptions, if you have an existing prior authorization that expired in December 2020 or January 2021, ask your doctor to call CVS Caremark at (800) 294-5979 to request prior authorization before you refill this medication.

 

If you are taking a long-term medication, now you can choose to receive your 90-day supplies by mail or pick them up at a CVS Pharmacy near you. Whether you choose delivery or pick-up, you will pay the same copay. This choice is being offered to you by the Health Plan as a way to help you and the Plan save money.

 

Fill limit for long-term medications

Your plan allows two 30-day fills of long-term medications at any pharmacy in our network. After that, your plan will cover long-term medications only if you have 90-day supplies filled through mail service or at a CVS Pharmacy. If you continue to have 30-day supplies of long-term medications filled at a retail pharmacy after two fills, you will pay the entire cost of the medication.stock meds

With Maintenance Choice, you can avoid paying more for your long-term prescriptions. All you need to do is have 90-day supplies filled by mail or at any CVS Pharmacy.

 

Questions & Answers

How do I transition my current maintenance medications to a 90-day supply?

If you already receive your long-term medications from CVS Pharmacy, CVS Caremark will contact your doctor about changing to a 90-day prescription if necessary. Beginning January 1, 2021, use Caremark.com or call us at 1-833-741-1361. CVS Caremark will contact you when you have your last allowable fill and work with your doctor to get a 90-day prescription based on your choice of CVS Pharmacy pick-up or mail service.

If you previously filled your maintenance prescription at a participating network pharmacy other than a CVS Pharmacy store, CVS Caremark will send you a reminder letter to contact your prescriber for a 90-day prescription. There are four ways that you can start filling in 90-day supplies:

  1. Bring your new 90-day prescription to a local CVS Pharmacy store location; OR
  2. Refill your prescription at Caremark.com. CVS Caremark will then contact your prescriber for your prescription information; OR
  3. Call CVS Caremark Customer Care at 1-833-741-1361, OR
  4. Fill out and send in a mail service order form. This order form will be included in the Welcome Kit that you will receive from CVS Caremark.

How should I ask my doctor to write my future 90-day prescription to receive the maximum benefit?

Ask your doctor to write a prescription for a 90-day supply (plus three refills, as appropriate) for long-term medications. The pharmacy must fill your prescription for the exact quantity noted on the prescription, up to your plan design limit. If you plan to use mail service for a newly prescribed medication, but need your initial fill immediately, ask your doctor for two prescriptions:  

  • The first for up to a 30-day supply, to be filled right away at any participating retail network pharmacy 
  • The second for a 90-day supply with as many as three refills (as appropriate) through a CVS Pharmacy or mail service.

 

customer service

For more information, visit Caremark.com, or contact the CVS Caremark Customer Care line at 1-833-741-1361.