What you need to know
You automatically have prescription drug coverage through CVS Caremark when you enroll in either of the High-Deductible Health Plans. You can use your HSA or HRA to pay for your share of the cost. You can fill covered prescriptions at participating CVS retail pharmacies or through the CVS Caremark mail service. For specialty medications, you’ll need to use specialty pharmacy services, as described below.
Until the deductible is met, all covered medical and prescription costs are applied against the deductible. You will pay the actual cost of your prescription, as negotiated between CVS Caremark and the pharmacy.
Need to fill a prescription?
Filling Your Prescription
You can fill up to a 30-day supply of a prescription at more than 5,000 participating pharmacies in the Connecticut, New York, and New Jersey area (64,000 nationwide), including major pharmacy and supermarket chains and most independent drug stores. Simply present the prescription and your CVS Caremark prescription drug card.
In an emergency or if you’re out of state and can’t get to a participating pharmacy, you’ll pay out of pocket and then file a claim for reimbursement from CVS Caremark.
Pay nothing for certain preventive drugs
The Affordable Care Act (ACA) makes many prescription medications, vaccines, and supplements—including contraceptives and statins—available to you at no cost.
No-cost vaccines when you use the right ID card
What You Pay for Fills
The High-Deductible Health Plans have a combined annual deductible for medical and prescription drug services. You’ll pay the full cost of services until you meet your deductible; for prescription drugs, you’ll pay the actual cost of your medication, as negotiated between CVS Caremark and the pharmacy.
Under these plans, the most you’ll pay out of pocket for medical care and prescription drugs in any calendar year is $3,000 per individual or $6,000 per family.
How much you’ll pay for your prescription depends on the type of medication and the amount prescribed. When the cost of a drug is less than the minimum copay, you’ll pay the lower amount.
Tier 1: Generic
30-day supply: $10 copay after deductible
31- to 90-day supply: $10 copay after deductible through CVS Caremark mail service
Tier 2: Brand Name
31- to 90-day supply: $50 copay after deductible through CVS Caremark mail service
Tier 3: Non-Preferred Brand
31- to 90-day supply: $80 copay after deductible through CVS Caremark mail service
A Word About Specialty Drugs
Specialty medications are available through the YNHHS Outpatient Pharmacy Services or the Apothecary & Wellness Center or the CVS Specialty Pharmacy. Specialty drugs are subject to the Advance Control Specialty Formulary. This formulary includes specialty generics and clinically effective brand therapies, and combines other specialty programs, such as Specialty Guideline Management to ensure proper utilization. For the most current formulary listing, visit the Caremark website or call CVS Caremark customer service at 877-636-0406.
7:30 a.m. to 5 p.m. ET
Choose the YNHH_PRD option
800-237-2767 (Specialty Pharmacy)