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Maintenance Medication Benefits

To provide additional savings to our members and promote mail service for maintenance medications, we offer employers several options. Members receive communications to promote cost savings opportunities for these medications they regularly fill:

 Maintenance Medication List

Name of benefit Which members may have the benefit Coverage
Mail Order with Retail Choice

Member fact sheet

Fully insured members
  • Standard benefit for employers with up to 50 employees
  • Opt-in for employers with 51 or more members
  • Allows members two fills of their maintenance medication at their retail pharmacy
  • By their third fill, the member must opt out of the mail service pharmacy to stay at a retail pharmacy
  • If the member continues to fill at the retail pharmacy without opting out of the mail service pharmacy, they’ll pay 100% of their medication cost at retail
Maintenance Choice Voluntary

Member fact sheet

  • Standard benefit for self-insured accounts who have our pharmacy benefits
  • Member can fill a 30-day fill at any retail pharmacy
  • Member has choice of using CVS Pharmacy (retail); or the CVS Caremark Mail Service Pharmacy for coverage of their 90-day fill
  • Use of a CVS retail pharmacy or the mail service pharmacy is not required for coverage
Maintenance Choice Exclusive

Member fact sheet

  • Self-insured employers can choose to offer this to their employees
  • Requires the member to fill a 90-day prescription for their medication
  • Allows members two fills of their maintenance medication at the retail pharmacy
  • By their third fill, members are required to transition to either CVS Pharmacy (retail); or CVS Caremark Mail Service Pharmacy  
  • If the member doesn’t use CVS Pharmacy (retail) or the mail service pharmacy, they’ll pay 100% of their medication cost at retail