CVS Caremark is the State Health Plan’s Pharmacy Benefit Manager for the 70/30 PPO Plan, the 80/20 PPO Plan and the High Deductible Health Plan. Members should note that this does NOT mean members have to go to a CVS pharmacy location for their prescriptions. CVS Caremark has a broad pharmacy network.
Under both health plans, the formulary, or drug list, for prescription drugs is a closed formulary. Under a closed formulary, certain drugs are not covered. Please note that there is an exception process available to providers who believe that, based on medical necessity, it is in the member’s best interest to remain on a non-covered drug(s).
Use the tools below to find a participating pharmacy near you. In addition, members have access to the drug lookup tools below to compare costs for various drugs covered under the plan.
Please note: If a drug is not covered, the following advisory will appear under Plan Notes in the Drug Lookup Tool: “Not covered: Ask your doctor about alternatives.”
CVS Caremark Customer Service can be reached by calling 888-321-3124.