Is there a generic drug available
A good choice
for my condition?
Remember, when you use a generic drug, you get the same quality as the brand-name drug – at a
Most likely, yes. Many commonly prescribed drugs
lower cost. To learn more about generic drugs, visit
have generic versions. In fact, nearly 63 percent of
our Web site or talk to your doctor or pharmacist.
prescriptions are now filled with generic drugs. Below are a few of the most common generics and their brand-name counterparts.
Need help or have any questions?
Visit our Web site or call Caremark Customer Care
Monday through Friday – 8 a.m. to midnight (EST)Saturday – 9 a.m. to 9 p.m. (EST)
If you have a hearing impairment and need
telecommunications device (TDD) assistance, please dial toll free: 1-800-863-5488.
Health and Prescription Information
Your health plan has selected Caremark to administer
your prescription benefit program. Caremark uses
Drug Card Program
health and prescription information of covered
calcitonin nasal spray
members and dependents to administer your benefit.
Caremark generally reports that information to your
health plan. Caremark also uses information and
prescription data gathered from claims submitted nationwide for reporting and analysis without
Your privacy is important to us. Employees at your
health plan and at Caremark are trained regarding the appropriate way to handle your private
The drug names listed above are the registered and/or unregistered trademarks of third-party pharmaceutical companies. These trademarks are included here for informational purposes only and are not intended to imply or suggest any affiliation.
Your Prescription Drug Card Program
What is a 3-tier plan?
Filing a Claim
Your prescription drug card program makes it easy
(Most benefits are based on a 3-tier plan. Refer to
If you always use network pharmacies for your
for you to receive the prescriptions you need. When
your benefit booklet to see if this applies to you.)
prescriptions, you’ll never need to file a claim.
you use a participating network pharmacy, you’ll
Prescription drugs in a 3-tier plan are divided into
For those rare times when you need to use a
have NO claim forms to file and NO waiting for
three tiers – Tier 1, Tier 2 and Tier 3. Each tier is
pharmacy that’s not in our network or if you ever
reimbursement. At network pharmacies, the
assigned a copayment or coinsurance amount, which
forget to show your pharmacist your ID card, you
pharmacist will use a computer to check your
is the amount you pay when you receive a prescription.
can file a claim for the amount you paid for your
eligibility for benefits and to determine the amount
Refer to your benefit booklet to find the amounts that
you will pay for prescriptions. If you don’t present
apply to you. Tier 1 drugs are generic drugs. For the
Pay the full amount of the prescription and
your ID card or you don’t use a network pharmacy,
lowest out-of-pocket expense, you should always
complete a Prescription Drug Claim Form.
you’ll have to file a claim and you may not be
consider Tier 1 drugs if you and your doctor decide
Mail your prescription drug receipt and your
reimbursed for the full amount you paid.
they are appropriate for you. Tier 2 drugs are preferred
brand-name drugs. Consider Tier 2 drugs if no Tier 1
How much will I pay for my drugs?
drug is available to treat your condition. Tier 3 drugs
Prescription Drug Claim Processing Center
are non-preferred and will usually cost you more. If
Your prescription drug card program allows you
P.O. Box 52059
you are using a Tier 3 drug, talk to your doctor about
and your doctor to choose the right drugs for you.
Phoenix, AZ 85072-2059
Tier 1 and 2 drugs that may be appropriate for you.
The amount you will pay for your drugs is based on
NOTE: Whenever a generic drug becomes available,
You can obtain claim forms on the Prescription
your benefit plan and the status of your drug on
most of the time the brand-name drug will automatically
Drug Information page on our Web site or by
our Preferred Drug List. For copayment plans, you
calling Caremark Customer Care toll free at
typically pay a fixed copayment amount depending
on the type of drug you receive. For coinsurance
Selecting a Pharmacy
Your reimbursement check should arrive within
plans, you will pay a percentage of the cost of the
With your prescription drug card program, it’s easy
10-14 days from the day you mail your claim form.
drugs. You may also pay a higher percentage
to use a network pharmacy. With more than 57,000
You will be reimbursed according to your schedule
network retail pharmacies to choose from, you’re sure
What is a Preferred Drug List (PDL)?
to find one that’s convenient for you. To locate a network pharmacy, refer to your network pharmacy
Save money with generics!
A PDL is a list of prescription drugs chosen for
directory. If you don’t see your pharmacy listed, check
If you want to lower your prescription drug costs,
their clinical value and cost-effectiveness by an
first with your pharmacy to see if it has been added to
consider using generic drugs. Choosing generics
independent panel of doctors and pharmacists.
our network since the list was developed. You can also
can be an excellent way to save money.
With our PDL, you and your doctor have the
use the pharmacy locator on the Prescription Drug
freedom to choose the prescription drug that
Information page on our Web site or call Caremark toll
works best for you. Since there may be more than
Are generic drugs safe?
free at 1-888-963-7290. On behalf of your health plan,
one drug available for your medical condition,
Absolutely! Generic drugs become available when
Caremark assists in the administration of this program.
we encourage you to use generic and preferred
patents expire on brand-name drugs. They contain
Caremark is an independent company that administers
brand-name drugs whenever possible to help you
the same active ingredients as brand drugs, but are
prescription drug benefits. You should always check
manage your prescription costs. Although our PDL
not manufactured under a brand name or trademark.
with your pharmacy to see if it is part of our network
is subject to change without notice at any time
The color and shape of a generic drug may be
before you have your prescriptions filled.
during the year, you can always find the most
different from its brand-name counterpart, but the
up-to-date PDL information on the Prescription
active ingredients are the same for both. Generic
Drug Information page on the Web site noted on
drugs must meet the same U.S. Food and Drug
Administration (FDA) quality standards as the brand-name drugs. You should always ask your doctor to allow a generic substitution if one is available.
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