Prescription Coverage is provided to all eligible employees † who enroll in Medical Insurance. Coverage will be effective on the date of hire or the first day of the semester
for faculty members.
The State of Rhode Island's prescription plan is administered by CVS Caremark. Prescriptions
can be filled at any in-network pharmacy. Please review the details below regarding
the prescription coverage, or contact CVS Caremark at www.caremark.com, or call the customer service number: 1-800-307-5432.
Key Plan Features for 2020
- Combined out-of-pocket maximum for medical and prescription
- New prescription drug co-pays and addition of a fourth tier for specialty drugs:
- Generic: $10
- Preferred Brand-Name: $35
- Non-Preferred Brand-Name: $60
- Specialty: $100
Maintenance Choice – Save money by obtaining 90-day supplies of long-term maintenance medications for
the co-pay price of a 60-day fill.
Transform Diabetes Care – A new program that provides resources like test strips and lancets and counseling
to help you manage your diabetes, all free of charge.
Click here to be redirected to the State Employee Benefits website and learn more
about the current prescription plan.
For more information regarding Medical Insurance, please visit: http://ccri.edu/hr/handbook/302Health.html
To obtain a 3 month supply of a prescription drug for 2 co-payments, use the form
provided for the CVS Caremark Mail Order Program. Additionally, please note that the Office of State Employee Benefits is implementing
a new RX Maintenance Choice (w/ Opt Out) program effective January 1, 2017. This program creates efficiencies in the pharmaceutical
delivery system that benefits both the state and you as the health plan member. Basically,
the program encourages you to utilize the mail-order/CVS-Target pick-up options for
90-day supplies of maintenance medications and realize savings. This method saves
the cost of a single co-pay, which over the course of the year can add up to several
hundred dollars. Some of you and your dependents surely already participate in this
program – it is currently voluntary. But beginning January 1, 2017, this program will
become mandatory unless you opt out by calling CVS Caremark. See below for a description
of how the program works.
To obtain reimbursement for out-of-network prescription claims, complete the CVS Caremark RX Claim Form and submit as instructed on the form.
- This program applies to maintenance (long-term) medications only.
- This program does not apply to short-term/acute medications.
- This program DOES NOT require a you to use CVS/pharmacy or Mail Service.
- This program is identical to the current Voluntary program, however, it requires you
to call CVS Caremark (1-800-307-5432) to opt out of 90-day maintenance medications.
- This program allows flexibility and choice:
- You can choose 90-day supply of maintenance medications at CVS/pharmacy or CVS Caremark
Mail Service Pharmacy or you can call Customer Care at 1-800-307-5432 to choose 30-day
supply of maintenance medications at other participating retail pharmacies. Once you
call CVS, covered long-term medications can be filled at any participating retail
pharmacy. You pay the retail copay for each 30-day supply.
- There is NO REQUIREMENT under the State of Rhode Island’s prescription drug plan to
HOW THE PROGRAM WORKS:
- After one fill of a maintenance medication at any participating retail prescription,
you will receive a letter from CVS Caremark with instructions. There are 2 separate
letters depending on where you fill your medications.
- Letter A: If you fill long-term medications at CVS /pharmacy:
- Informs you that the CVS pharmacist will be reaching out to your doctor to obtain
a new medication for a 90–day supply.
- There is no further action required by you.
- You will pay the lower 90-day copay for maintenance medications.
- Letter B: If you fill long-term medications at any other participating retail pharmacy
explains your choices:
- You can choose to call your doctor, obtain a 90 day supply of your maintenance medication
and fill at Mail Service or CVS/pharmacy.
- You can call CVS Caremark at 1-800-307-5432 and tell Customer Care you want to OPT-OUT
of 90 day supply maintenances. Once you contact CVS to opt-out, you will be allowed
to fill your maintenance prescription at any participating retail pharmacy at 30-day
supply copay. You will be opted out of 90-day maintenance medications for all other
maintenance medications you may be taking. This allows your eligible covered medications to be dispensed at any participating
retail pharmacy without having to call CVS Caremark with every medication.
Please note that the Maintenance Drug List is intended to be illustrative and is not
The CVS Caremark Flyer describes the 90-day Maintenance Choice options available to you. For those so inclined,
mail order is a great way to save money and not wait in lines at the pharmacy. It
is relatively hassle-free and they even schedule helpful reminder phone calls and/or
text messages when re-fills are due. CVS Caremark will also facilitate your doctor
providing the prescription so you don’t have to. Visit www.caremark.com/wps/portal/WELCOME_PAGE to learn more general information about the web-based services CVS Caremark offers
and register an online account. The CVS Caremark home page is www.caremark.com.