Prescription Drugs

YOUR MEDICAL COVERAGE INCLUDES PRESCRIPTION DRUG COVERAGE

The coverage that’s available to you depends on your union’s negotiated collective bargaining agreement (CBA). If eligible, see your collective bargaining unit’s Health Care Benefits Supplement. It’s posted to the Reference Center in your MyBenefits Online account. It includes which carrier administers your medical coverage and therefore whether your prescription drug coverage is through CVS Caremark or Kaiser Foundation Health Plan of the Northwest (Kaiser NW).

If Kaiser NW administers your prescription drug coverage, log in to your MyBenefits Online account for more detailed coverage information. If your coverage is through CVS Caremark, here are highlights of your coverage (your MyBenefits Online account also includes more detailed coverage information).

Coverage through CVS Caremark includes a:

Retail program (up to a 30-day supply): For short-term medications obtained at a CVS Caremark network pharmacy (includes pharmacies other than CVS retail pharmacies).
Mail-order program or CVS retail pharmacy (up to a 90-day supply): Only for long-term or maintenance medications filled through the mail-order program or at any CVS retail pharmacy.
Specialty prescriptions program (up to a 30-day supply): Medications must be filled through mail-order or at a CVS retail pharmacy beginning with the first prescription.
Depending on your negotiated CBA, the PrudentRx Copay Program may also be available to you through CVS Caremark for covered specialty prescriptions. See your collective bargaining unit’s Prescription Drug Supplement to confirm if PrudentRx is available. By opting into this program, you don’t pay for certain covered specialty medications after you meet any applicable deductible requirement.

You can fill an initial prescription for a long-term maintenance medication (one that you need for more than 60 days), plus two refills, at any in-network retail pharmacy. After that, depending on your union's negotiated CBA, you may be required to fill that prescription through CVS Caremark's mail-order program, at a CVS retail location, or at additional select pharmacies. See your collective bargaining unit's Prescription Drug Supplement to confirm.

COVERAGE SUMMARY

FOR SPECIALTY MEDICATIONS

Depending on your union’s negotiated CBA, the PrudentRx Copay Program may also be available. Through this program, you can receive covered specialty medications at no cost after you meet any applicable deductible requirement (when filled at CVS Specialty®). If you or your covered dependent is receiving covered specialty medications, PrudentRx will send you additional details—including how to affirmatively enroll in the program. If you don’t enroll, a PrudentRx Advocate will reach out to you directly with more information regarding your options.

If the PrudentRx Copay Program is available to you but you don’t participate, you’ll pay 30% coinsurance for any covered specialty medication. In addition, even if your medication is considered an “essential health benefit,” the coinsurance you’ll pay will only apply to your coverage option’s applicable out-of-pocket maximum.

Questions? Contact CVS Caremark, or call PrudentRx at 1-800-578-4403 (representatives are available Monday through Friday, 7:00 a.m. to 7:00 p.m., Central Time).

SAVE WITH Rx SAVINGS SOLUTIONS (RxSS)

Rx Savings Solutions (RxSS) is designed to help you save money on your medications and make switching to a lower-cost prescription easy. RxSS is integrated into your prescription drug coverage through CVS Caremark. It doesn’t replace or change your coverage. It’s simply an additional voluntary tool that offers confidential personalized suggestions and cost-saving opportunities given your specific prescription needs. With RxSS, you can:

Access Cost-Saving Alternatives: RxSS pharmacists identify equally effective, lower-cost medication alternatives that are covered by your MDLZ-sponsored prescription drug coverage. These alternatives can include a generic option, taking your medication in a different form (i.e., capsule-tablet, ointment-cream, etc.), or using an alternative pharmacy that can fill your prescription at a lower price.
Manage and Compare Costs: Once you activate your RxSS account, you can view your options and compare prices. Your account also lists the medications you’ve already filled, making it easy for you to manage everything from one place.
Receive Alerts and Notifications: RxSS contacts you via email, direct mail, or a text message when you’re spending too much on current medications or regarding any new ones you may be prescribed in the future.
Learn About Your Options: Have a conversation with RxSS's concierge team and/or utilize RxSS's mobile/web-based app to learn about your personalized savings opportunities. RxSS has a team of certified pharmacy technicians ready to help you start saving.
Easily Switch to Lower-Cost Medications: If you decide to switch to a more affordable prescription option, RxSS coordinates with your doctor to get their approval beforehand. RxSS then works with your pharmacy to make sure your prescription-switch request is completed.
Share Access with Covered Family Members: They too can activate their own account and manage their prescribed medications.

How to Activate Your Account

Go to myrxss.com. You may find these step-by-step instructions helpful.

How to Access Rx Savings Solutions:

By Phone: Call 1-800-268-4476. Connect with an experienced pharmacy technician who can answer your questions and facilitate a prescription switch on your behalf.
By App: Access your personalized prescription portal from your mobile device or computer at myrxss.com. Here, you can learn all about your savings opportunities, view real-time pricing for all covered medications, search for alternative pharmacies, and initiate a prescription switch.

If you need additional help, email support@rxss.com or call 1-800-268-4476. You can view this 10-minute on-demand webinar, and get answers to more frequently asked questions here.

QUESTIONS ABOUT HOW CVS CAREMARK COVERS A SPECIFIC PRESCRIPTION DRUG?

Call CVS Caremark at 1-888-771-7267. You can also access online preventive and formulary drug lists through the CVS Caremark website. Please note that only drugs on the formulary listing are covered.