Next time you have a prescription to fill, follow these steps to make sure you understand the plan rules, save money and take advantage of the many resources available to help you.
1. Ask for Generics
To avoid paying more for your prescriptions, always ask your health provider if a generic alternative is available. If not, ask about a preferred brand alternative. As you discuss your options, you and your provider should be aware of the following plan rules.
- If your prescription is written for a brand name medication, it will be filled with a generic, if available. If your provider requires the brand medication, you’ll pay a brand penalty (the cost difference between the generic and brand name drug) plus the applicable brand coinsurance.
- Prescriptions for certain brand name medications will require you to use a generic or preferred brand name drug first. In this case, the pharmacist will contact your doctor and request a new prescription. If you try this alternative drug or have tried one in the past and it does not work for you, then your doctor can request that the original brand name medication be covered by the plan. Otherwise, if your doctor chooses the brand name drug you were initially prescribed, you will have to pay the full cost of the drug and it will not apply to your deductible or out-of-pocket maximum. (Visit caremark.com to see the complete list of medications that fall under this category.)
2. Understand How You Pay
Your prescription drug costs depend on both the type of drug used and your medical plan option.
If you are in the HRA option:
- You don’t have to meet your medical deductible first. You pay a copay for generic medications and coinsurance for brand name medications.
- If you take medication for high blood pressure, high cholesterol, diabetes (medications only) or heart failure, Rockwell Automation will automatically pay more of the cost for these drugs compared to other drugs covered by the plan. This is called a “value-based prescription coverage benefit.”
- A prescription drug out-of-pocket maximum limits how much you have to pay for prescription drugs during the year.
If you are in the HSA option:
- For preventive medications, you pay 20% of the cost and you don’t have to meet the medical deductible first.
- For non-preventive medications, you must meet the deductible first. Once you meet your deductible, you pay coinsurance for your medications.
3. Use Your Tools
You have access to several tools that help you manage and understand your prescription drug benefits, including how much you’ll pay for your medications:
- CVS Caremark Website. Find network pharmacies, see your plan coverage, check drug costs and the availability of generics, see which brand name medications require a generic first, learn about your medication, order prescription refills and discover ways to save on your medications.
- CVS Caremark mobile app. Use your iPhone or Android phone to identify unknown pills, check for potential drug interactions, refill prescriptions, find network pharmacies, check coverage and cost under your plan and review your prescription history.
- Prescription Drug Wizard. Answer a few questions to get specific information about your prescription drug plan, including how much you’ll pay for a prescription.
- Quick Find. Get basic information about your coverage and plan rules by typing “prescription drugs” in the search field.
- Caremark Customer Care (1.800.421.2342). Call Customer Care for answers to questions about your prescriptions.
- Your Medical SPD. Have a more detailed question about your prescription drug benefits? Find the Summary Plan Description (SPD) for your medical option at EmployeeConnect > Your Benefits Resources.
4. Fill Your Prescription
You have two ways to fill your prescription:
- At a retail pharmacy. You can fill your prescriptions—up to a 30-day supply—at a CVS Caremark retail pharmacy. To find one near you, visit caremark.com.
- Through mail order. If you take a maintenance drug—a prescription you take on an ongoing basis to treat a chronic condition—you can fill the first two 30-day supplies from any network retail pharmacy before you are asked to receive any additional fills in a 90-day supply from CVS Caremark Mail Order or a local CVS pharmacy (CVS Caremark’s Maintenance Choice program).
These four steps cover the basics of your prescription drug benefits and the tools available to you. If you have additional questions, call the Rockwell Automation Service Center at 1.877.687.7272, Monday through Friday, 8 a.m. to 4 p.m. Central time.