Caremark Prescription Drug Plan
Prescription drug coverage is provided through Caremark for Plans A and B, and its cost is included in the health plan rates. While the Preferred Drug List (PDL) is the same for all plans, the amount you pay will vary depending on the plan you select as explained below.
Plan A and Plan B. Under these plans, generally you pay a coinsurance for your prescription drug costs throughout the year, up to a combined coinsurance maximum. Regardless of which plan you elect, your out-of-pocket costs will be lower if you use generic and/or preferred brand name drugs. Your cost for generic drugs and preferred brand name drugs is considerably lower than your cost for non preferred brand name drugs. Before talking to your physician about prescriptions, it is suggested that you print out the preferred drug list from the website and take it with you so you can talk to your doctor about your options. If the physician says you must take a brand name drug, ask if there is a preferred brand name drug listed on Caremark’s PDL that you can take. This PDL is updated quarterly so please check for updates throughout the year.
Caremark’s PDL is available on the open enrollment website - click on the 2010 Open Enrollment button at www.khpa.ks.gov then select Prescription Drug Coverage or go to www2.caremark.com/kse. You can also call Caremark at 800-294-6324. A number of popular name brand drugs are projected to be available in generic versions by the end of 2010. This list is also on the website.
A new change to the PDL for 2010 would be that you must try a generic drug before you will be approved for a non preferred brand name drug for three classes of drugs: high blood pressure, high cholesterol and stomach acid reducers called proton pump inhibitors. These effected drugs include high blood pressure medications (ACE/ARBs) such as Diovan, Cozaar and Hyzaar; stomach acid reducers, such as Prilosec and Aciphex, and cholesterol lowering drugs like Vytorin and Zocor. Those currently using a non preferred drug will be notified by Caremark.
The Caremark plan is designed to encourage you and your health care provider to choose the most cost-effective and clinically-effective medications available. The benefits in the tables listed on the comparison chart included apply when you purchase prescription drugs from a participating Caremark network pharmacy or Caremark home delivery. Plans A and B allow up to a 60-day supply for home delivery through Caremark and reorders are processed in as little as five to seven days. To place an initial order or reorder by phone, call 1-800-294-6324 or e-mail online@caremark.com
Specialty and biotech drugs designed for difficult conditions that don’t respond to traditional therapy, including cancer, MS, hemophilia, rheumatoid arthritis, hepatitis C and growth hormones, are available only at Caremark Connect Specialty Pharmacy. Contact Caremark Connect at 1-800-237-2767. A Caremark representative will coordinate patient care with the provider and arrange overnight shipping.
For more information on the Caremark Prescription Drug Plan, go to www.khpa.ks.gov and click on the 2010 Open Enrollment button - then select Prescription Drug Coverage or call Caremark at 1-800-294-6324.
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