Page 15 - Saddleback EE Guide 07-20 v.7 FINAL

Prescription Drugs

If you are enrolled in a Saddleback Church Medical plan, you will automatically receive pharmacy benefits through
CVS Caremark. We chose CVS Caremark for prescription benefit coverage so you can be confident you’re receiving the
best care and service available.

CVS Caremark Maintenance Program
As a member, you will receive a 90-day supply of long-term (maintenance) medications for the cost of only one mail
order copay (Generic $20 / Brand Name $60 / Non Formulary 50%) by visiting a CVS Caremark retail pharmacy or by
using the CVS Caremark mail-order pharmacy. You also have the option to set up your maintenance medications
through mail order by contacting CVS Caremark Member Services at (800) 776-1355.

To Register Online
Go to www.caremark.com. CVS Caremark offers online resources to help you learn about and
manage your prescription benefits. As a registered user, you’ll have 24/7 access to a
pharmacist from the privacy of your home. Use the CVS Caremark website to manage your
prescriptions, compare drug costs, locate participating pharmacies, obtain order/claim forms,
submit mail order refills, and check on the status of CVS Caremark mail orders.

CVS Caremark Mobile App
With the CVS Caremark Mobile App, you have immediate and secure access to refill and renew
home delivery prescriptions, track order status, and much more. Download the app using
AppStore for iPhone or Google Play for Android.

Anthem Blue Cross Anthem Blue Cross

Plan Name EPO Plan PPO Plan
Network Name CVS Caremark CVS Caremark Non-Network
Deductible $0 $0 N/A
Retail Pharmacy—30 Day Supply
Generic $10 Copay $10 Copay Not Covered
Brand Name Formulary $30 Copay $30 Copay Not Covered
Brand Name Non-Formulary 50% 50% Not Covered
Retail or Mail Order Pharmacy—90 Day Supply
Generic $20 Copay $20 Copay Not Covered
Brand Name Formulary $60 Copay $60 Copay Not Covered
Brand Name Non-Formulary 50% 50% Not Covered

Note:
If you or your physician request a brand name drug Locating a Retail Pharmacy
when a generic equivalent is available, then you will Go to www.caremark.com. Once logged in,
be responsible for the brand name drug copay plus the you may search for a pharmacy using your
difference between the retail cost of the brand name home or work zip code.
drug and the generic drug.

Employee Benefits 15