Medical / Prescription Drugs

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Prescription drug coverage through CVS Caremark is included when you enroll in the Anthem PPO or Anthem Advantage HSA Plan.

You have the option to fill your 90-day prescriptions at your local CVS pharmacy or through the CVS Caremark mail order pharmacy- state law permitting.

You may also fill 30-day prescriptions at CVS and other participating reta il pharmacies including Target and Walgreens. Learn more about participating pharmacies at caremark.com or by calling 1-844-387-1432.

Watch these quick videos:

Getting to Know Your Prescription Benefits | CVS Caremark

Get the Most Out of Your Rx –
Tips Everyone Should Know:

Did you know?

If you purchase a covered drug from a non-network pharmacy such as Cost Plus Drugs, GoodRx, and Amazon Pharmacy you may submit a paper claim form to CVS Caremark so the cost to you is applied to your deductible.

Steps for Submitting a Paper Claim Reimbursement Form

How to Submit a Paper Claim Reimbursement Form

1. Review the Dos and Don’ts.
2. Download, fully complete and print the Paper Claim Reimbursement Form at CVS Caremark or call 844-387-1432 and request a form
3. Attach receipts to a separate piece of paper; do not attach to the claim form.
4. Make copies of your submission and retain for your records.
5. Mail to the address indicated on claim form- Claims will be processed within 30 business days

Do:

  • Do complete the Paper Claim Reimbursement Form that corresponds with the RxBIN number on your ID card.
  • Do make a copy of your prescription receipt(s) and include with the claim form.
  • Do ensure the following is included on your pharmacy receipts or provide on the claim form:

If your plan has Coordination of Benefits (COB), you may submit a paper claim for consideration of your secondary benefit. Be sure to include primary claim payment information and EOB (explanation of benefits) to avoid delays in processing your claim.

Request a receipt from the pharmacy that includes all of this standard data.

  • Date of Fill
  • Pharmacy information (NABP number, name, phone number, full address)
  • Prescriber’s NPI number, DEA number and/or FULL name
  • Prescription number
  • NDC number
  • Total charge
  • Quantity
  • Days supply

Don’t:

  • Do Not include Mail Service Order Form with your paper claim submission.
  • Do Not send in a cash register receipt except for diabetic supplies.
  • Do Not send medical or dental claims.

Contact CVS Caremark at the number on the back of your ID card if you have any questions regarding your claim(s).

Medication Levels and Cost

Cost for medications vary based on the level of the drug selected by the healthcare provider.

The three levels are:

Generic – Generic prescription drugs include the same active ingredients as their brand-name counterparts, at a lower cost. Smiths Group requires all prescriptions to be filled using generics.

  • If you fill the prescription with a brand-name drug, you will pay the applicable cost between the brand-name and generic drug.

  • If you receive a prescription for a brand-name drug where there is no generic available (a single-source brand drug), you will continue to pay the applicable brand copay.

Brand Preferred – These drugs are typically a bit more expensive than generic drugs. Before you fill a prescription, you can check to see which drugs are brand preferred at caremark.com.

Brand Non-Preferred – These are the most expensive drugs. If your doctor prescribes a brand-name drug that is not on the preferred drug list, you will pay the highest cost.

Take advantage of mail order now and save time and money:

  • FREE shipping right to your door
  • Up to a 90-day supply for just one mail order copay
  • 24/7 access to a registered pharmacist from the privacy of your home
  • Order refills online, by mail or by phone – anytime, day or night
  • Automatic refills every three months if you choose the auto-refill option.

Advantages of Mail Order