PRESCRIPTION DRUGS
CVS Caremark® Prescription Drug Coverage 2025 and 2026
Your medical plan includes prescription drug benefits through CVS Caremark® for generic, brand and specialty prescriptions.
| What You Pay | ||
| Type of Prescription Drug | Retail (30-day supply) | Mail Order (90-day supply) |
| Generic preventive drugs, no deductible | $2 copay | $5 copay |
| All other generic drugs | 10% after deductible* ($10 minimum, $50 maximum) | 10% after deductible ($25 minimum, $125 maximum) |
| Preferred brand drugs | 20% after deductible* ($25 minimum, $100 maximum) | 20% after deductible ($65 minimum, $250 maximum) |
| Non-preferred brand drugs | 40% after deductible* ($50 minimum, $175 maximum) | 40% after deductible ($100 minimum, $425 maximum) |
*Deductible does not apply to the Copay EPO Plan.
There is no out-of-network prescription drug benefit. This means if you get your prescription filled at out-of-network pharmacies, you will not be reimbursed by the medical plan. You’ll be responsible for 100% of the cost, and it will not count toward your deductible or out-of-pocket maximum.
90-Day Supply
The CVS Maintenance Choice® program requires you to fill maintenance prescriptions for a 90-day supply at any CVS Pharmacy® or through CVS Caremark Mail Service Pharmacy. To help you stay on track with your medication, CVS offers auto refills and refill reminders via text. The coverage will allow up to two initial 30-day fills. After that, you will be automatically enrolled in the Maintenance Choice program.
If you wish to continue to obtain maintenance drug prescriptions at a non-CVS pharmacy or in 30-day fills, you may do so but must first opt-out of the Maintenance Choice program by contacting CVS Caremark. You will be required to opt out each plan year by contacting customer care. If you purchase the drug without first opting out of the program, you will be required to pay 100% of the cost of the drug at the pharmacy.
30-Day Supply at Retail
You can fill up to a 30-day supply at any in-network pharmacy.
Specialty Prescriptions
CVS Specialty® allows you to fill prescriptions for specialty medication used to treat complex conditions with pills or by injection or infusion. You can have your medication delivered anywhere nationwide or pick it up at any CVS Pharmacy location.
Some medications may require prior authorization. Watch the video to learn more.
Stay in network to save
Your medical plan does not cover out-of-network prescription drugs. If you fill a prescription at an out-of-network pharmacy, you will pay 100% of the cost.
CVS® HealthHUB™
Now open in more than 1,500 locations, CVS HealthHUB locations provide expanded in-store health services, chronic condition care, pharmacy support and more — all in one place for your convenience.