Understanding your prescription benefits

State Health Plan coverage includes prescription benefits at no extra cost. Prescription drugs are covered at network pharmacies only, and Caremark is the pharmacy benefits manager. Explore the information below to learn more about your prescription benefits.

If you have questions about State Health Plan prescription drug benefits, call Caremark at 833.291.3646. For questions about SilverScript, the Plan's Medicare prescription drug program, call 833.293.4859.

Medicare Part D notifications

If you received a letter from Express Scripts about disenrollment from Express Scripts Medicare effective December 31, 2025, you do not need to do anything. PEBA will automatically enroll you in SilverScript, the State Health Plan’s new Medicare prescription drug program effective January 1, 2026, and there will be no interruption in your prescription drug coverage.

Find covered drugs

PEBA will use Caremark’s Advanced Control Specialty Formulary; however, the State Health Plan might not cover certain medications regardless of their appearance on the document linked below. Members will be able to create Caremark accounts in mid-December. After they create an account, they can search for a network pharmacy and price medications covered by the Plan.

State Health Plan

State Health Plan specialty medications