Benefits

Health Plan - Pharmacy

What pharmacies participate in the Caremark network?
Caremark has a nationwide network with more than 56,800 pharmacies including most major chain, discount, grocery and independent pharmacies. To locate a participating pharmacy when you are traveling, please call the Caremark customer service number on the back of your pharmacy card or use the "Find a Pharmacy" feature on Caremark Web site. Your customized benefits booklet also lists the nine closest participating pharmacies, based on ZIP code.

What kind of help can customer service offer?
You may speak to a pharmacist about a prescription, get additional information about your benefits, request additional ID cards and determine if your local pharmacy is part of the Caremark network. The customer service number is (800) 503-3241. The service center is open 24 hours weekdays, 9 a.m.-8 p.m. (EST) on Saturday and 9 a.m.-6 p.m. on Sunday.

What is the Caremark HealthLine?
The HealthLine is a telephone information and education center members can call for answers to common health and medication related questions. You can call (866) 744-4848 toll free to be connected to pharmacists and technicians who have received training in various health care areas.

How do I submit a manual claim for a prescription I had to pay full price for at the counter?
If you did not have your prescription drug card with you at the time of service or if you used an out-of-network pharmacy, you can submit a Direct Member Reimbursement Form (pdf) to Caremark.

When can I use mail service?
Mail Service is designed for maintenance medications, which are long-term medications used to treat conditions such as diabetes, arthritis, heart conditions, high blood pressure, etc. You can receive up to a 100-day supply of your medications through Caremark Direct, with free home delivery.

How do I use the mail service?
When your doctor prescribes a maintenance drug, ask to have the prescription written for up to a 100-day supply. If your medication must be taken immediately, ask your physician to issue two prescriptions: one for a 30-day supply to be taken to your local pharmacy, and a second for a 100-day supply to be mailed to Caremark Direct. Complete a Confidential Mail Service Enrollment form (pdf), which is available on Caremark's Web site and in your benefit booklet.
You only need to complete this form for your first order. Write your employee ID number on the back of each prescription and mail the enrollment form, along with the original prescription and copayment to Caremark Direct. Your medication will usually be delivered within two weeks.

What should I do if I need an additional or replacement Caremark prescription drug cards?
You can call Caremark customer service or you can visit the website and request that a replacement card be sent to you and/or you can print a temporary card to take with you to the pharmacy.

What is the Caremark Specialty Pharmacy?
Patients with complex, chronic medical conditions work one-on-one with the Caremark Specialty Pharmacy, which provides a full complement of specialized drugs and services for patients with cancer, infertility, hemophilia, multiple sclerosis, rheumatoid arthritis, HIV/AIDS, and several other conditions. For more information on the Caremark Specialty Pharmacy, visit (800) 621-4787 or visit the Member Services section of www.caremark.com.

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