Prescription Plans-HR @ Carnegie Mellon University - Carnegie Mellon University

Prescription Plans

Carnegie Mellon prescription coverage through CVS/Caremark provides access to numerous chain and independent pharmacies, in addition to mail order service for maintenance medication.

There are two plan options available, which differ by employee contribution rates, copays/coinsurance rates, and coverage for non-preferred drugs. View a Coverage Comparison Chart [pdf] of our prescription plans.

Prescription Plan Rates

Prescription Drug Participant Copays/Coinsurance

Caremark
Option A
Caremark
Option B
In-Network Retail
(Up to 30-day supply)
Generic (automatic substitution)
$10
$5
Brand–Preferred $25 You pay 35%
($100 maximum)
Brand–Non-Preferred $40 You pay 100%
Specialty

$100

$100

Mail Order or Maintenance Choice (Up to 90-day supply)
Generic (automatic substitution)
$20
$10
Brand–Preferred
$50
You pay 35%
($200 maximum)
Brand–Non-Preferred
$80
You pay 100%
Annual Out-of-Pocket Max (separate from medical out-of-pocket max)
 
$2,650 individual/ $5,300 family
$2,650 individual/ $5,300 family
  • When a generic is available but the pharmacy dispenses the brand-name medication for any reason, you will pay the difference between the brand-name drug and the generic drug plus the generic copayment.

Prescription Drug Summary of Benefits and Coverage Notices

Carrier Resources

Caremark
Customer Service: 877-347-7444
Pre-authorization: 888-414-3125
www.caremark.com

Pharmacy Locator

Direct Reimbursement Form [pdf]

CVS/Caremark Mobile App Information [pdf]

Preventive Care Services

Your health plan offers certain preventive service benefits at no cost to you. These no-cost benefits are part of the Affordable Care Act (ACA). View the CVS/Caremark Preventive Services List [pdf].