Understanding Your Rx Plan
The more you know, the easier it is to get your medication and find ways to save. Explore the links, videos and downloads below to learn how to make the most of your prescription drug plan.
Learn more about Western Health Advantage’s switch to CVS Caremark:
2027 Check Drug Cost Tool:
Certain medications may be subject to prior authorization, step therapy, quantity limitations, or other coverage review requirements at the time of pharmacy processing. Final coverage determination and member cost share are established upon processing of the prescription.
- Individual and Family Plans Formulary
- Federal Employees Health Benefits Formulary
- Small Group Plans Formulary
- Small Group and Large Group Plans with Fertility Formulary*
*Medications for fertility services are excluded on small group plans, unless the employer has elected plans with fertility coverage.
Note: The prices shown in the tool are estimates only and not a guarantee of payment amount or benefits. Final cost is determined by your benefit plan (copayment, coinsurance, or deductible status). Pricing may change based on pharmacy location and quantity.
Additional Information:
- Safe Disposal of Unused or Expired Medications
- The best way to dispose of most unused or expired medications is through an authorized drug take-back location or mail-back program. Do not share medications with others.
- If a take-back option is not available, follow the FDA’s instructions for safely disposing of medications. Do not flush medication unless it appears on the FDA’s approved flush list.
- Place used needles, syringes, lancets, and auto-injectors in an approved sharps disposal container. Never place loose sharps in the trash or recycling. Visit the FDA’s sharps disposal page for more information.
Videos
DIY with Digital Tools
Discover digital tools that help you make the most of your Rx plan benefits. Learn about your personalized savings and find easy ways to manage your prescriptions on your own time. To access our digital tools, sign in or register
at Caremark.com.
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Your prescription plan has a lot to
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offer sign in at caremark.com, or download
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our mobile app to find affordable medication pricing Network,
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Pharmacy, choices, savings, and support all
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built right into your account with our
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drug cost and coverage tool. You can explore ways
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to save money on your medications.
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And help ensure you're not paying more than you need to buy finding a pharmacy
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in your network.
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You can also review drug savings opportunities.
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Personalized, just for you.
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When it comes to filling your prescriptions, you've got options.
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Save time by getting your medications refilled automatically.
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Or place your own orders online.
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Or through our mobile app in just a few steps.
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Plus track the status of your orders. So, you
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know, when they're on the way,
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To help better understand your coverage. You can review your plan and
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financial summaries.
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See where you're at with your deductible and keep track of prescription
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expenses.
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It's also a good idea to set your communication preferences, so you
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can stay informed about savings opportunities, refills,
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and order status.
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To learn more visit, caremark.com.
Save time and get your Rx online
Fill or refill your prescription online in a few simple steps with our easy-to-use tools. To order your medication online, sign in or register at Caremark.com
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Refill, your
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prescriptions in just a few steps with our easy-to-use
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online tools.
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Get started by signing in or registering for an account at
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caremark.com.
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After signing in.
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You'll see a list of all your prescriptions ready for refill.
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Simply select the ones you need and follow the prompts to submit your
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order. We'll contact your doctor for approval, if
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necessary, and then process and ship your order within
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7 to 10, business days.
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You can also choose to get real-time text alerts. Whenever your prescription
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is ready for refill, plus get alerts on your order status
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payments.
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And more to learn more visit
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care mark.com.
Prescription coverage & prior authorizations
Your Rx plan may require prior authorization for certain medications to help keep costs in check. If a prior authorization is required, we’ll work with your health care provider to ensure you get the right medication at the lowest possible cost. To learn more about prior authorization, sign in or register at Caremark.com
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Making sure you have access to medications at the lowest
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possible cost is our priority.
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To help. Keep.
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Costs low, your plan covers a list of medications used to treat
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most conditions. This list is sometimes
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called your drug formulary.
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It's important to review this list with your doctor so they can try to
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prescribe an effective medication. That's also covered by your
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plan.
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The easiest way to see which medications are covered is to sign into your
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caremark.com account and review your plan info.
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You can also use our drug cost and
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coverage tool with your doctor to compare your options
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before you fill a prescription.
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If your doctor still prescribes a medication that isn't covered by your plan,
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then you may need prior authorization,
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This process ensures certain criteria is met before your
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plan will cover your prescription.
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There are a few reasons, why a prior authorization might be required.
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the medication may be unsafe when combined, with other
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medications you're taking
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Used only for certain health conditions.
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Have the potential for misuse or abuse?
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Or an effective alternative might be available.
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If your medication does require a prior authorization,
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you should speak with your doctor to see if an alternative
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is available, if not, then you or
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your pharmacist can ask your doctor to start a prior
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authorization.
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Will then work with your doctor to get additional information that will
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help us to determine if the medication should be covered.
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The process can take several days and depends on how complete
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and quickly information is provided and reviewed.
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If approved, you can fill your prescription. If deny,
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you'll receive a letter and then you can ask
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your doctor. If there's another medication covered by your plan,
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that may also work for you. If you have not already
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Choose to pay for the medication yourself at a retail pharmacy.
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Or you or your doctor can submit an appeal by
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following the steps in your letter.
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To learn more visit, caremark.com.
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The.
Additional Video Resources
Looking for more information? Explore the supporting videos below for additional guidance and helpful insights related to your prescription benefits.
Tracking Your Prescription Mail Order Stay on Track with Automatic Refills
Plan Downloadables
Welcome to CVS/Prescription Benefits
Convenient and cost-effective medication options
Rx home delivery
Medications delivered right to you
Generic medications
Your plan offers generic options
Digital benefits
Looking to save time and money?
Specialty
Specialty medication support just for you
ACA Preventive Services Drug List