Prescription Plan

Please review the covered drug lists within the document section on this page or call CVS Caremark to confirm drug coverage as formulary updates are made every quarter.

What's changing for 2025

Due to significant increases in our pharmacy costs, there are several changes to the prescription drug benefits for all four plans, so please review carefully.

• NEW: Preventive drug coverage changes
  Brand-name preventive drugs and diabetic supplies will no longer be covered at 100%. Regular brand-name drug copays and coinsurance will apply after you meet your deductible. Generic preventive drugs will no longer be covered at 100%. These generics will cost $4 per 30-day fill at a retail pharmacy. Your deductible does not apply to these medications.


• NEW: GLP-1 drug coverage
  If you are taking a GLP-1 medication for diabetes, your doctor must provide medical records to confirm your diabetes diagnosis before you can fill your prescription. GLP-1 medications are high-cost brand drugs, so you must pay your deductible and 30% coinsurance before our plan begins to pay for your prescription.


• NEW: High-cost brand and specialty drugs
  In addition to GLP-1 medications, you will pay 30% coinsurance after deductible for other high-cost drugs like CGRP migraine medications, Paxlovid, and all specialty drugs. Some specialty drugs are free if you enroll in the PrudentRx program. View the Important Documents page for the current list of high-cost brand drugs, which may change quarterly.

A prescription for savings

• You will automatically receive the lower of our benefit plan price OR the GoodRx price for participating drugs. This happens automatically when you fill your prescription at participating pharmacies and your cost will count towards your deductible, even if the GoodRx price is used.


• Tell your doctor you are concerned about cost. Some doctors can look up your cost and find cheaper options during your appointment. Confirm your doctor prescribes the generic version, if available.


• Stay at home and save! Use the CVS Mail Order Pharmacy to save money with 90-day supplies for your regular prescriptions. You can call CVS to opt out if you want to pick up 30-day supplies at your local pharmacy, but you may pay more.


• Go shopping! Check prices online with the Check Drug Cost tool at www.caremark.com. You can also use manufacturer copay coupons or financial assistance programs. Any financial assistance amounts will not count towards your deductible or out-of-pocket maximum for the year.