Page 12 - 1800Flowers 2022 Benefits Guide

Prescription Drug Plan

The prescription drug program is managed through CVS Caremark.
Pharmacy Advisor Counseling
While you can choose to fill prescriptions at any in-network pharmacy, If you fill a prescription at CVS for one
as a member of the CVS Caremark program, you will have access to: of the following conditions, you may be

• 20% off CVS brand pharmacy products eligible for counseling with a pharmacist.
We encourage you to talk to your
• Fill a 90-day supply of a maintenance medication at a
CVS pharmacy pharmacist to help you understand your
treatment plan and effects of certain
Certain preventive care prescription drugs, as designated by the medications. Conditions include:
Affordable Care Act (ACA), are covered at 100% by the plan at no cost • Diabetes • Osteoporosis
to you, the member. The plan also covers additional preventive care
prescription drugs outside of the ACA designation. These prescriptions • Asthma • Depression
bypass the medical plan deductible and are only subject to the • Heart Disease • Certain cancers
coinsurance and out-of-pocket maximum.
Maintenance Prescriptions:

You can fill maintenance prescriptions at a retail pharmacy or through mail order. However, after two 30-day fills at a retail
pharmacy for the same maintenance medication, you should use either a retail CVS pharmacy or the CVS Caremark Mail
Order. Otherwise you will pay an additional cost equal to 2.5 times the retail cost share of the prescription.
Don’t forget — you can fill a 90-day supply of a maintenance medication at a CVS pharmacy.

You will be able to search for in-network pharmacies and view a prescription formulary list on the benefits marketplace.

Additional Requirements for Some Prescription Drugs

1 Certain medications require prior authorization by CVS Caremark.

Some drugs require step therapy. This means that if you are prescribed a brand-name medication,
2 you might be required to first try a generic medication or other therapy before the plan will cover
the brand-name medication.

Generic vs. Brand-Name Drugs — “Dispensed as Written (DAW)”
3
If you or your health care provider request a brand-name drug at your pharmacy, you are responsible
for the difference in cost between the generic drug and the brand-name drug, in addition to the generic
copay. Note that extra charges for DAW don’t apply to your deductible or annual out-of-pocket maximum.

We encourage you to discuss generic use with your provider in advance of the prescription being written
in order to avoid extra charges or additional visits to your physician/provider.

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