Prescription Claims
When you go to a pharmacy within the CVS Caremark network, you should only be responsible for your copay. Covered prescriptions filled at a non-network pharmacy should be filed with CVS Caremark, the Health Plan’s prescription benefit manager, for reimbursement. If you purchase prescription medication at a non-network pharmacy:
- You will not receive the network discount;
- You will have to pay the full amount at the time of purchase; and
- You will have to file a claim form for a partial reimbursement as follows:
Step 1: Fill out the Prescription Drug Claims Form.
- In the Group No./Group Name field, write in the RxGRP from your CVS Caremark prescription card.
- In the Identification Number field, write in the ID that appears on your CVS Caremark prescription card.
Step 2: Be sure to include prescription receipts with your claim form.
Step 3: Submit your claim.
| DO NOT submit claims to the Health Plan Office.
Mail your completed form and additional information to: CVS Caremark |
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CVS Caremark will reimburse you for the amount they would have covered at the discounted rate, less the applicable co-payment amount.
