Changes to the CVS/Pharmacy Formulary
Our new formulary excludes drugs with generic alternatives. If you currently take medication that is not covered under the new formulary, Caremark sent you a letter with applicable information so that you can discuss alternatives with your doctor.
If you visit your doctor and need medication, ask your doctor to prescribe a generic version of the medication needed. Before you fill a prescription, always check to be sure the medication is on the formulary list, which is updated each quarter. You can view the formulary list online at www.Caremark.com or call 1-877-MyTHRLink, prompt 3.
Some brand drugs require prior authorization, step therapy (trying an alternative drug first) and/or quantity limits.
- Prior Authorization: This means that your doctor must contact CVS/ Caremark (1-855-582-2026) and confirm that a specific medication meets plan guidelines for covering your condition.
- Step Therapy with Post-Step Prior Authorization: You must try a lower-cost alternative before a higher-cost medication will be covered. If you have a unique medical situation where the lower-cost alternative doesn’t work well for you, your doctor must contact CVS/Caremark (1-855-582-2026) and confirm that a specific medication is clinically necessary for your condition.
- Quantity Limit: The plan limits the amount of a specific medication that you can fill in a 30-day or 90-day period. If you have a unique medical situation that requires you to exceed the limit, your doctor can contact CVS/Caremark (1-855-582-2026) and confirm that a higher quantity is clinically necessary for your condition.
You can find a comprehensive list of covered drugs along with any specific criteria at www.Caremark.com and a Caremark representative will answer any question you may have about your specific prescriptions, just call 1-877-MyTHRLink, prompt 3.