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HELP CENTER
HELP CENTER
Find your answer in these topics:
Visit the CVS Caremark Welcome Center!
Discover savings and support tools that make the most of your pharmacy benefits.
Visit the COVID-19 Resource Center
Get up-to-date information on reimbursement for at-home COVID-19 tests.
Visit the CVS Caremark Welcome Center!
Discover savings and support tools that make the most of your pharmacy benefits.
Visit the COVID-19 Resource Center
Get up-to-date information on reimbursement for at-home COVID-19 tests.
Order Status and History
Cost and Coverage
Ordering Prescriptions
Payments and Billing
Medication Use and Safety
Web and Account Support
Glossary
* Order Status and History
* Cost and Coverage
* Ordering Prescriptions
* Payments and Billing
* Medication Use and Safety
* Web and Account Support
* Glossary
* ORDER STATUS AND HISTORY
1. What does my order status mean?
We have five main order statuses. They include:
In Process: We're reviewing and processing your order to get it ready
for shipping.
On Hold: Your order was placed on hold either by request or because
there was an issue that needed to be addressed before filling the
order. Here are some of the possible reasons an order would be placed on
hold:
* We need clarifying information from you or your doctor.
* If you’re a Medicare member, you may have to provide consent before
we ship an order to your address.
* A copay may be higher than a specified threshold, and we hold the
order as a courtesy so you can review and provide payment consent.
* There’s a lower-cost generic alternative than your name-brand
medication, so we’ll put the order on hold so you can decide if you’d
rather talk to your doctor about the generic drug.
If your order is on hold because of a payment issue, make sure that you
don’t have an outstanding balance and that your payment methods are up
to date.
In the event of a hold, we’ll notify you and direct you to take the
appropriate action to continue your order.
Future Fill: Your order was received before its next refill is
available, so it's been scheduled for the next soonest fill date.
Rejected/Canceled: We couldn't process your order because of conflicts
with the order, or your medication was not covered by your plan. Check
the Order Details page for more information on why this happened.
Shipped: Your order has been picked up by the carrier and is in transit.
Check the Order Details page for a tracking link once your order has
been shipped.
Stay informed with email or text updates about your medication mail
order status, including when it will arrive. To start tracking your
medication mail order, sign in or register at Caremark.com.
Tracking your Rx mail order
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2. How do I know when my order will arrive?
You can view your order status online. Before the order ships, we will
provide an estimated delivery date. Once it is shipped, you can visit
the tracking page of the carrier. Selecting "Track your order" will take
you to the carrier’s tracking site. If you are enrolled for email
alerts, the order tracking number will be included.
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3. Why can't I see my prescription?
You may not be able to view prescriptions in your Caremark.com account
for several reasons:
1. Your prescriptions were recently transferred to us and we haven't
added them to your online account yet.
2. Your prescription is processing or an order has recently shipped,
and your medication isn't currently available for refill. Check
the View/Refill All Prescriptions page.
3. Your prescription was mailed in, but is not yet eligible for refill.
We will do one of the following:
* Keep your prescription on file and fill it in the future.
* Automatically fill your prescription on the next available date.
* Place your prescription on hold and require that you request to
have it released.
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4. My order says it's processing. Why hasn't it shipped?
Medications for new prescriptions and renewals will generally ship 4-5
business days after we receive the order. Medication refills will
generally ship 1-2 business days after we receive the order. You can
usually expect to receive your medication 7-10 business days after we
receive your order.
During this time, we may contact your doctor for any information we
need. We also verify that we have your medication in stock. Then we
prepare and package the order.
If we don't hear back from your doctor or find another issue, your order
status will switch to “On hold,” and we’ll notify you so you can take
the appropriate action.
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5. What would cause my prescription to be placed on hold or canceled?
Your prescription may have an item on it that is unclear to the
pharmacist reviewing it. This could be the date written, the strength of
the medication, the dosage, instructions, etc. Some prescriptions may
require additional authorization from your doctor. Insurance or payment
issues could also hold up an order. If you receive a notification that
an order is on hold, we’ll provide directions on what you can do to lift
the hold.
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6. What payment method is being used for my order?
You can view your payment methods in My Billing Information. On this
page, you can update your current payment methods or add a new payment
method.
You can set any payment method to be your default method, or you can
choose your payment method each time you place an order.
If you would like to change the method of payment on an open order, you
will need to call Customer Care using the number on your member ID card.
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7. I didn't place an order. Why is an order being processed or shipped?
When we receive a prescription electronically, by phone or by fax, we
start to process it to get it to you quickly. Your order may be
processed because:
* Your doctor placed an order on your behalf.
* You may have set up automatic refill of the prescription. If there’s
another member on your account, that person may have placed an order
or set up automatic refills or renewals.
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8. Why can't I see when my doctor sends in a new prescription and when it
is placed on hold or canceled?
If any part of a new prescription is missing, it will not be displayed
as "in process." If it is a current or new prescription that was placed
on an indefinite hold, you will need to restart the prescription before
you will be able to see it on the website.
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9. How do I find out the status of my mail service prescription order?
For easy tracking of your order, we encourage you to sign up for order
status alerts via email or SMS. You can also check the status of your
order online by signing into your Caremark account and going to the View
Order Status page.
If you can’t access your online account, you can contact Customer
Care. Please have your member ID card, and either the prescription
number or order confirmation number ready when you call.
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10. How do I cancel my order?
A regular refill, auto refill, or future refill order can be canceled if
it is still “In Process” and not yet shipped.
To cancel a prescription, follow these steps:
1. In the top navigation menu under Prescriptions, go to View Order
Status.
2. On the View Order Status page, find the order you want to cancel.
3. Under the order number, select Change this Order. You will then go
to the View/Change Order page.
4. On the View/Change Order page, select Fill Later or Stop. A window
will open.
5. In the window, a calendar will display. Select Stop this
Prescription. A confirmation window will display with the
prescription details.
6. In the confirmation window, select Stop this Prescription to cancel
your prescription order.
If you need to return an item that has shipped, please contact Customer
Care for assistance.
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11. A medication order is being shipped, and the message from CVS Caremark
didn't include the patient or medication name. How do I find out more
about the order?
You can see your recent orders and prescriptions on your dashboard. If
you have multiple household members on your account, the prescription
component will identify the medications prescribed for each member. In
some cases, your account may have restrictions on who can view this
information.
For future orders, you can set your preferences to include the name of
your medication in your Rx Delivery by Mail order status communications.
To do this, sign into to your account and select Profile at the top of
the page, then select Communication Preferences. Scroll down the page to
Drug Name Display and select edit. Choose Show Abbreviated Drug Name or
Show Full Drug Name and click on the Save Changes button.
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12. Why did I receive a different medication than what my doctor originally
prescribed?
Your pharmacy benefit plan likely offers lower-cost alternatives to the
medication that was prescribed. In that case, CVS Caremark may contact
your doctor to suggest either a generic version or a brand-name
medication on the plan's preferred list. Your doctor may choose one of
these options if it is appropriate for you. This may change from the
original prescription you received and may save you money.
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13. I’d like the name of my medication to show in my Rx Delivery by Mail
order status communications. How can I make this change?
To add a prescription name to your order status or refill
communications, sign into your account and select Profile at the top of
the page, then select Communications Preferences. Scroll down the page
to Drug Name Display and select edit. Choose Show Abbreviated Drug Name
or Show Full Drug Name, then click on the Save Changes button.
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* COST AND COVERAGE
1. Is my medicine covered under my prescription benefit plan?
To find out if your medicine is covered, you can use our Check Drug Cost
and Coverage tool. Fill in the requested information about the medicine
and dosage and you'll receive a message telling you if your medicine is
covered and what your co-pay amount will be. You'll also find out if
there is a generic or a preferred medicine available that can help save
you money.
Find out if your medication is covered – or if you could pay less for it
– with our Check Drug Cost & Coverage tool. Plus, see if you can save
money with options like delivery by mail or changing to a generic
medication. To explore ways to save, sign in or register.
Compare Rx costs and coverage
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2. Why does my medication cost a particular price?
There are several factors that can affect the price of a medication,
including the following:
* Payment toward your deductible
* A change in your co-pay
* A percentage-based copayment
In some cases, you may see the cost of a more expensive brand
medication, even though you are purchasing a generic. This would be
changed to the generic price when the order is processed. You can check
your coverage for a medication and find out how much that medication
will cost by using our Check Drug Cost and Coverage tool.
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3. How can I find out how much a medication will cost and if it's covered
under my prescription benefit plan?
You can look up the price of a medication using the Check Drug Cost and
Coverage tool. When you search for a drug, you can see how much of the
medication costs your plan pays and how much you pay. This information
is listed under the price of the drug. For certain medications, the
quantity or dosage cannot be changed.
Fill in the requested information about the medication and dosage and
you'll receive a message telling you if your drug is covered and what
your copay amount will be. You'll also find out if there is a generic or
a preferred alternative available that can help save you money.
You may also look up the price of a drug you previously searched for
(desktop only) or a prescription you previously filled through CVS
Caremark Mail Service Pharmacy.
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4. Does the cost of a drug change depend on where I purchase it?
Yes, the cost may vary by pharmacy and whether you use mail order or a
retail store, depending on your plan. The Check Drug Cost and Coverage
tool shows you the cost of a drug at the pharmacy or pharmacies you
select.
If you have not used the Check Drug Cost and Coverage tool before, you
will need to select a default pharmacy.
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5. Why don't I see a price when I search for my medication?
If the drug you are searching for is not covered under your plan, no
price estimate will display.
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6. Can I see how much money a generic medication would save me?
Yes. The best way to look for savings is to search for a medication
using the Check Drug Cost and Coverage tool. Any generic or other
options and their prices will display in the results. In some cases, a
plan may only cover the generic version, which is also shown in the
results.
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7. Where can I find the preventive drug list covered under my plan?
You can view your covered drug list (formulary) by going to the Covered
Drug List page. All formulary lists are on this page, including the
preventive drug list. When reviewing the formulary list, check any
medications to ensure plan coverage.
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8. Why does the website provide a price quote that may be different than
when I ordered my prescription?
The price is an estimate based on many factors and may vary depending on
the type of plan you have. For example, a percentage-based co-pay will
change based the current cost of the medication. Plan details can vary
from year to year, so details of your plan can vary even if you are with
the same benefit provider with the same level of coverage. An additional
fee may be added if you chose expedited shipping. In some cases, the
website may not reflect the deductible or out-of-pocket accumulations
being applied towards your prescriptions.
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9. How do I change the quantity or dosage for my search?
When you price a new drug using the Check Drug Cost and Coverage tool,
you can change the dosage by clicking on the "Edit" link under "Dosage"
which will display once the drug name is entered and selected.
The quantity for the prices shown is based on the dosage for the
medication. By default, this is set to the mail order dosage for that
particular medication. For instance, if the most common dosage is once
per day, the price displayed for a 90-day supply would include 90 pills.
For certain medications, the quantity or dosage cannot be changed.
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10. What is my deductible? Where can I find information about my deductible
and out of pocket that have accumulated this year?
Your deductible is the amount you pay toward a medical expense before
insurance begins covering costs. You can view your current accumulations
towards your individual/family deductible, and individual/family maximum
out-of-pocket by looking under Plan and Benefits, then click on Plan
Summary on the dropdown box.
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11. What is the coinsurance or co-pay for my plan? How do I know what I'm
going to have to pay for my prescriptions?
Coinsurance and co-pay are the amount that you are responsible for
paying when you get your prescription filled. After you pay the co-pay
or coinsurance, your plan will cover the rest of the cost, if any. The
amount is determined by your plan sponsor's pharmacy benefit.
Coinsurance is typically a percentage of the total cost. For instance,
if you have a medication that costs $100, and your coinsurance is 20
percent, you will pay $20, while your plan pays $80.
A co-pay is a fixed amount that you will pay. For instance, you may have
a co-pay of $15, which is what you will pay regardless of the total
cost.
You may view your co-pay and Coinsurance details in your Prescription
Plan Summary. To determine your specific co-pay, check your Check Drug
Cost and Coverage.
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12. How far back can I view my past prescription costs on the web?
You can view prescription costs, from January of the previous year to
the present date, on Caremark.com in the Prescription Plan Summary
page. For reports prior to the available dates and up to 7 years or
more, contact Customer Care.
Records may not be available from previous coverage with a different
pharmacy benefit manager.
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13. I want to find pharmacies with a specific service or feature.
When you select a pharmacy in the Check Drug Cost and Coverage tool, you
can specify that you would like to see only pharmacies with specific
features (such as on-site medical clinic or open 7 days a week). In the
pharmacy locator, select Advanced Options to see a list of services you
can select from.
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* ORDERING PRESCRIPTIONS
1. I currently pick up my specialty medications at CVS Pharmacy. Can I get
them by home delivery?
Yes, CVS Specialty® patients can have their medications delivered to
their homes with no delivery charge. If you would like your specialty
medications delivered to your home, you will need to change your
delivery preference. To get started, sign in to CVSspecialty.com and
change your delivery preference.
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2. If I opt into having my medications delivered through CVS Caremark, does
the delivery require a signature?
Our national delivery partners are also working to implement new
policies for deliveries requiring signatures, including for shipped
medications, which can help plan members adhere to recommended social
distancing practices and avoid potential exposure to the virus.
For example, in lieu of obtaining actual signatures, UPS will now enter
a code and the name of the recipient so that the member does not have to
physically sign via the UPS hand-held device, which can help minimize
contact.
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3. Do I need to fill out a form to fill my prescription by mail?
No, you don’t need to complete a form. You can sign in to Caremark.com
and select Start Rx Delivery by Mail to get started.
Note: You cannot access Start Rx Delivery by Mail from the CVS Caremark
app. You may access this service from a web or mobile browser.
If you prefer to mail your prescription, you can download and print
a Mail Service Order form:
* Mail Service Order Form - English (pdf)
* Mail Service Order Form - Spanish (pdf)
Complete and mail the form along with your 90-day prescription and
payment to the address shown on the form. You may pay by credit or debit
card (VISA®, MasterCard®, Discover®, American Express®), check or money
order, or electronic check.
You can also call the Customer Care number on your member ID card to
have a form mailed to you.
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4. How long does it take to receive my Mail Service prescription?
You can expect to receive your medication within 7 to 10 business days
after we receive your order.
Sign in to Caremark.com and select Start Rx Delivery by Mail and we will
contact your doctor and get the process started for you. Once we reach
you doctor and receive approval, it will take 7 to 10 business days to
process and ship your order.
Note: You cannot access Start Rx Delivery by Mail from the CVS Caremark
app. You may access this service from a web or mobile browser.
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5. How do I have 90-day supplies of my medications mailed to my home or
location of my choice?
When you use Start Rx Delivery by Mail, you can choose to have your
medication mailed to your home, office or other location of your choice.
Delivery is contactless and there are no shipping fees.
To start filling by mail, you’ll need a new 90-day prescription. You can
either:
* Ask your doctor to send an electronic prescription to CVS Caremark
Mail Service Pharmacy. This is the easiest way to get started – we
will process and ship your order in 7 to 10 business days.
OR
* Sign in to Caremark.com and select Start Rx Delivery by Mail and we
will contact your doctor and get the process started for you. Once we
reach you doctor and receive approval, it will take 7 to 10 business
days to process and ship your order.
Note: You cannot access Start Rx Delivery by Mail from the CVS Caremark
app. You may access this service from a web or mobile browser.
If you prefer to mail your prescription, you can download and print
a Mail Service Order form:
* Mail Service Order Form - English (pdf)
* Mail Service Order Form - Spanish (pdf)
Complete and mail the form along with your 90-day prescription and
payment to the address shown on the form. You may pay by credit or debit
card (VISA®, MasterCard®, Discover®, American Express®), check or money
order, or electronic check.
You can also call the Customer Care number on your member ID card to
have a form mailed to you.
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6. How do I request a new prescription from my doctor so I can start Rx
Delivery by Mail?
The best way is to call your doctor and ask to have a new 90-day
prescription sent to CVS Caremark Mail Service Pharmacy electronically.
If you’re having trouble reaching your doctor, sign into Caremark.com
and select Start Rx Delivery by Mail.
Note: You cannot access Start Rx Delivery by Mail from the CVS Caremark
app. You may access this service from a web or mobile browser.
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7. What is the Automatic Refill program?
When you enroll qualified prescriptions into the program, we will
automatically refill and ship your prescriptions to you at the
appropriate time. We will also contact your doctor to renew an enrolled
prescription before the last refill or the prescription is about to
expire.
You can select which prescriptions to have filled automatically.
However, not all prescriptions may be eligible for the service. The
service is available for many common maintenance medications taken for
long-term therapy, such as medications for managing high blood pressure,
high cholesterol and diabetes. Medications such as controlled
substances, specialty drugs and prescriptions covered by certain
government payers, including Medicare Part B, are not eligible.
When you enroll a prescription in the service, you will need to choose a
payment option. You will also need to select a preferred method of
communication (either automated phone call, email or text message) to
receive notices about upcoming automatic refill orders. If you select
automated phone calls or text messages, please note that you may also
receive notices by email or the U.S. postal mail.
Make sure you never miss a dose by signing up for automatic refills. You
can count on us to keep an eye on your prescription and take care of
refilling for you. To enroll in automatic refills, sign in or register.
Stay on track with automatic refills
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8. How do I enroll for automatic refills?
Create an online account or log in to an existing account and select the
eligible prescriptions you want to enroll. You can also call the number
on your member ID card and we’ll take care of enrolling your
prescriptions into the program for you.
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9. How do automatic refills work?
Here's how the service works:
* Enroll your eligible prescription(s)
* We will automatically refill and mail your qualified prescription
before your refill due date, subject to your right to cancel any
order
* We will contact your doctor to renew your prescription (that is,
obtain a new prescription for the same medication) when it is either
out of refills or about to expire
* We will alert you before your prescription is refilled, at which time
you may change or cancel the order
You will always have an opportunity to change or cancel any automatic
refill order before we begin processing it. You will have at least ten
(10) days to change or cancel the order. If we do not provide you with
at least ten (10) days to cancel, we will accept a return of the order
and issue a full refund, including postage (if applicable). If you
cancel all or part of an automatic refill order, the prescriptions you
cancel will no longer be refilled automatically and will be unenrolled
from the service.
If you do not cancel your automatic refill order, your prescription will
be processed and shipped. Your current payment method will be charged
for your co-pay when the order ships.
Copayment, co-pay or coinsurance is the amount a plan member is required
to pay for a prescription in accordance with a plan. The amount may be a
deductible, a percentage of the prescription price, a fixed amount or
other charge, with a balance, if any, paid by a plan.
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10. How soon after I receive an automatic refill notification will I receive
my prescription?
You will have at least ten (10) days to change or cancel your automatic
refill order. Once the cancellation period has expired and you have not
cancelled the order, we will begin processing your refill and it should
ship within the next five (5) business days.
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11. How do I start Rx Delivery by Mail?
To start filling by mail, you’ll need a new 90-day prescription. You can
either:
* Ask your doctor to send an electronic prescription to CVS Caremark
Mail Service Pharmacy. This is the easiest way to get started – we
will process and ship your order in 7 to 10 business days.
OR
* Sign in to Caremark.com and select Start Rx Delivery by Mail and we
will contact your doctor and get the process started for you. Once we
reach your doctor and receive approval, it will take 7 to 10 business
to process and ship your order.
Note: You cannot access Start Rx Delivery by Mail from the CVS
Caremark app. You may access this service from a web or mobile
browser.
Remember, because CVS Caremark Mail Service Pharmacy fills prescriptions
in 90-day supplies, it can be used for medications you take regularly
(like high blood pressure, diabetes, or high cholesterol medications).
For short-term medications (like an antibiotic), use a retail pharmacy
in your plan’s network. You can find one by using the Pharmacy Locator
at Caremark.com.
Fill or refill your prescription online in a few simple steps with our
easy-to-use tools. To order your medication online, sign in or register
at Caremark.com.
Save time and get your Rx online
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12. I received a message to refill my prescription. I can't tell which
medication this is for.
You can call our automated voice response system at 1-800-552-8159, 24
hours a day, 7 days a week and follow the prompts to determine which
medication is ready to refill.
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13. How do I find out the status of my mail service prescription order?
For easy tracking of your order, we encourage you to sign up for order
status alerts via email or SMS. You can also check the status of your
order online by signing into your Caremark account and going to the View
Order Status page.
If you can’t access your online account, you can contact Customer
Care. Please have your member ID card, and either the prescription
number or order confirmation number ready when you call.
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14. Can I get my prescriptions filled at my local pharmacy?
It depends on your plan. Use the Pharmacy Locator tool to see what
in-network pharmacies are located near you. Sometimes you can save money
on your medications by filling your prescriptions by mail. You can find
out by using the Check Drug Cost and Coverage tool.
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15. How do I find out if I have refills left on my mail service
prescription?
You can find the number of available refills on your prescription label.
You can also find your prescription refill details on the View/Refill
All Prescriptions page. If no refills remain or your prescription is
expired, contact your doctor to renew the prescription. To see how many
refills are left, find the prescription and click the Show Details
button.
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16. I need my medication, but my mail service prescription has no refills
left. What should I do?
If you have no refills left, don’t worry – we can contact your doctor to
renew your prescription for you. Just sign in to Caremark.com and place
your refill order as you normally would (select View/Refill All
Prescriptions under the Prescriptions menu). Once we receive your order,
we’ll contact your doctor, get authorization for the renewal, and
process your refill as usual.
If we are unable to contact your doctor, don’t get a response, or your
doctor doesn’t authorize the renewal, you’ll receive a letter in the
mail. You can also check the status of your order online by signing into
your Caremark account and going to the View Order Status page.
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17. I need a refill on a different prescription than the one you texted me
about. How can I get a refill on the correct prescription?
You can check online by going to View Order Status, then selecting the
prescription you want to refill.
If you received a reminder text, go to the View/Refill All Prescriptions
page for more details about your prescription.
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18. Where can I find a list of in-network pharmacies I can use?
You can locate a list of pharmacies in your network by using the
Pharmacy Locator tool.
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19. What is prior authorization?
A prior authorization (PA) is an extra level approval that benefit plans
require for certain medications before they can be covered. A PA makes
sure that you're getting the right medication for your condition. It may
also help keep costs down so you don't overpay.
If your medication requires prior authorization, this means your plan
needs more information from your health care provider before a decision
on whether to cover the medication is made.
The medication your doctor prescribes needs to meet certain requirements
to be approved by your benefit plan. These requirements help ensure that
the medication is right for you.
Our Prior Authorization page has additional information on step therapy,
quantity limits and formulary medications. You can also check your prior
authorization status online.
Your Rx plan may require prior authorization for certain medications to
help keep costs in check. If a prior authorization is required, we'll
work with your health care provider to ensure you get the right
medication at the lowest possible cost. To learn more about prior
authorization, sign in or register at Caremark.com.
Rx coverage and prior authorizations
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20. When is a prior authorization required?
It depends on your benefit plan. Here are common reasons a prior
authorization is needed:
* There may be a lower-cost option that’s just as effective.
* The medication has potential for misuse or abuse.
* The medication is for certain conditions or diagnoses.
Our Prior Authorization page has additional information on step therapy,
quantity limits and formulary medications. You can also check your prior
authorization status online.
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21. How does the prior authorization process start?
You or your pharmacy can ask your doctor to start the prior
authorization process. Then, your doctor sends us the required
information by phone, fax or electronically. In some cases, your doctor
can submit the information electronically and get a decision instantly.
You can check your prior authorization status online.
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22. How does a prior authorization work?
We gather additional information from your doctor that’s required by
your benefit plan. This information helps determine if the prescription
is covered. We notify you and your doctor whether your prior
authorization is approved or denied as soon as possible – usually within
a few days.
Our Prior Authorization page has additional information on step therapy,
quantity limits and formulary medications. You can also check your prior
authorization status online.
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23. What can I do if my prior authorization is denied?
You have several options:
* Ask your doctor if there’s another medication that will work for you.
* Choose to pay for the medication yourself.
* Submit an appeal by following the steps in your denial letter.
You can check your prior authorization status online.
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24. How do I transfer my prescription from a retail pharmacy to CVS Caremark
Mail Service Pharmacy or from mail service to a retail pharmacy?
1. To transfer from retail to mail: Sign in at Caremark.com and choose
Start Rx Delivery by Mail under the Prescription menu. Then, search
for your medication and dosage. Select an option with “90-day supply
mail service” and click “Request a new prescription”. Review your
order and click or tap “Submit Refills” to request a 90-day supply
of your Rx. We’ll contact your doctor for approval and process your
order.
Please note: It may take a few days for your order to be processed.
You cannot access Start Rx Delivery by Mail from the CVS Caremark
mobile app. You can access this tool from a web or mobile browser.
2. To transfer from mail to retail: Ask your doctor or pharmacist to
send your prescription to a local pharmacy. All the information you
need is on the label of your current prescription medication. Sign
in at Caremark.com and use the Pharmacy Locator to find network
pharmacies near you.
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25. How do I order compound, controlled or specialty prescriptions?
You can order these types of prescriptions as follows:
Compound Medications
Due to guidelines issued by The United States Postal Service, CVS
Caremark cannot mail compound prescriptions.
If you would like to fill your prescription at a local pharmacy, use the
Pharmacy Locator tool to search for pharmacies that fill compound
medications. Be sure to select "Compound medications" as a filter.
The price of the compound medication will be available once the request
is submitted through your insurance.
Controlled Medications
If your medication is a Class 2 (or Schedule II) controlled substance, a
new prescription must be mailed or sent electronically by your doctor
(if allowed by state law). CVS Caremark will process the prescription
request.
Specialty Medications
Select specialty drugs will be covered through our network of specialty
pharmacies. You can view the list of covered drugs on our Specialty
Pharmacy page.
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* PAYMENTS AND BILLING
1. How do I get a refund on a mail order prescription?
You can ask for a refund by calling the phone number on your prescription
ID card or by submitting an online request to Customer Care.
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2. How do I receive a reimbursement for a prescription filled at a pharmacy?
CVS Caremark® has made prescription reimbursements as easy as possible.
There are several ways to request a reimbursement:
1. If you paid out of pocket for a prescription at a local pharmacy and
did not use your insurance benefits, the quickest way to request
reimbursement from your insurance plan is to ask for a refund at the
pharmacy where your prescription was filled. You will need to provide
the pharmacy with your insurance information. You may want to bring
the pharmacy prescription leaflet (the large piece of paper stapled
to the prescription bag) to the pharmacy.
Depending on the pharmacy’s policy, you will need to make your
request within 7 to 14 calendar days from the date of purchase. After
that time, the pharmacy will not process your prescription
reimbursement claim.
You may also use one of the following ways to process your
prescription reimbursement claim.
2. You can also download and complete a Paper Claim Reimbursement form,
located on the Print Plan Forms page. You must include the original
prescription receipt.
Once you complete the form, mail it to the address listed on the
form. Be sure to make a copy of the completed form and prescription
receipt and retain them for your records. If there is missing
information, you will receive a notification in the mail.
Once the form is received by our Claims team, they will review the
claim for processing. If approved, your reimbursement will be
processed within 45 business days. If you don’t receive a response
within that time, you can contact Customer Care for an update.
Please note that when you submit a prescription claim, CVS Caremark® does
not guarantee reimbursement of that claim.
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3. I'm trying to pay my account balance online but my payment will not
process. What is the reason?
There may be a few reasons for this problem:
* The order is active, in process, or has been placed in future fill
* The order has been canceled. The order will be shown as "processing"
for approximately 30 days before the order is released
* The order is being auto renewed
Please note:
* You can make a payment after your order processes
* You cannot pay a past due balance until your current order has shipped
* You can also mail your payment to CVS Caremark. When you mail in a
payment, be sure to write the invoice number and your ID number
(located on your member ID card) on your check. Mail your payment to:
CVS Caremark, Inc.
P.O. Box 659539
San Antonio, TX 78265-9539
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4. Will I be told the cost of my order?
When refilling your prescription online or by phone, you can receive an
estimated cost before completing your order. The price of your medicine
may change slightly due to pricing fluctuations.
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5. How can I find my account balance?
After logging in, you may view your balance near the top, right side of
the page.
Another way to see your account balance is to go to Mail Service Account
Balance and Payment. Your balance will display on the page.
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6. What forms of payment does CVS Caremark® accept?
For online transactions, CVS Caremark accepts VISA® and/or MasterCard®
credit and debit cards, American Express®, Discover® and electronic
checks. If you order by mail, we accept checks, money orders, and credit
and debit cards.
* You can update the My Billing Information page to keep your Flexible
Spending Account (FSA), Health Savings Account (HSA), or Health
Reimbursement Arrangement (HRA) card on file for future orders. If you
set your card as the default, it will be used for all future orders.
Members of some prescription benefit plans may be able to choose a
monthly payment plan.
If you have an FSA/HSA/HRA card, you can use it to pay at the checkout,
when placing a refill order, or to pay existing mail service balances.
You can also use the card when you edit an open order that has not been
shipped.
You may also be able to use a manufacturer coupon to lower your
out-of-pocket costs.
* Most CVS Pharmacy® stores accept manufacturer coupons
* CVS Specialty® accepts manufacturer coupons, also called manufacturer
copay cards, which must be presented directly to CVS Specialty.
Please note: CVS Caremark Mail Service Pharmacy does not accept
manufacturer coupons.
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7. Do I need to order prescriptions to pay an outstanding balance online?
You do not have to order prescriptions to pay an outstanding balance
online.
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8. I'm receiving an error when I try to update my credit card information.
Why is this happening?
If you have unsuccessfully attempted to update your credit card
information, you may get an error message because the "Name This Account"
field is not filled in.
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9. Why do I see duplicate charges for the same order?
You may see two pending charges because there is both a bank
authorization hold and a payment charge. The bank hold is not a duplicate
charge, and it will disappear automatically after the order processes.
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* MEDICATION USE AND SAFETY
1. What is my medication used for?
The medication you take can be used for different health conditions. You
may want to consult with your doctor or pharmacist for information about
a particular drug's use.
To find out what your specific medication may be used for, visit
our Drug Reference and Interactions database. Enter the name of your
medication in the "Drug Name or Condition" search field to get
information about it.
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2. What should my health care teams know before I begin taking my
medication?
Depending on your specific situation, certain medications may not be
right for you. You should make sure that your doctor is aware of your
health history, health conditions, drug allergies, and any other
medications or vitamin supplements you are taking.
To find out if your health conditions or current medications may
interact negatively with a new medication, visit our Drug Reference and
Interactions database. Enter the name of your medication in the "Drug
Name or Condition" search field to get information about it, including
any possible negative interactions.
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3. How should I take my medication?
You should take your medication as your doctor prescribes. You may want
to consult with your doctor or pharmacist for more information about a
particular drug's use.
If you need more information about how to take your drug, visit our Drug
Reference and Interactions database. Enter the name of your medication
in the "Drug Name or Condition" search field to get information about
it.
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4. What if I miss a dose of my medication?
You may want to consult with your doctor or pharmacist for more
information about a particular drug's use.
To learn what to do if you miss a dose of your medication, visit our
Drug Reference and Interactions database. Enter the name of your
medication in the "Drug Name or Condition" search field to get more
information, including what to do if you miss a dose.
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5. What other prescription medications, over-the-counter (OTC) medication
or foods may interact with the medication I'm currently taking?
To find out about possible interactions with food or OTC products, you
may want to consult with your doctor or pharmacist for more information.
To find out about possible interactions with food or OTC products, visit
our Drug Reference and Interactions database. Enter the name of your
medication in the "Drug Name or Condition" search field to get
information about possible interactions.
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6. What type of side effects might I experience?
Medications may affect each of us differently. You may want to consult
with your doctor or pharmacist for more information about a particular
drug's side effects.
To find out the possible side effects of the medication you're taking,
visit our Drug Reference and Interactions database. Enter the name of
your medication in the "Drug Name or Condition" search field to get
information about possible side effects.
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7. What do I need to watch for while I am taking my medication?
To find out if your medication has specific warnings you should be aware
of, you may want to consult with your doctor or pharmacist for more
information.
To find out if your medication has specific warnings, you can also visit
our Drug Reference and Interactions database. Enter the name of your
medication in the "Drug Name or Condition" search field to get
information about possible warnings.
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8. Where should I store my medication?
Some medications have specific storage requirements. To find out how and
where to store your medications, you may want to consult with your
doctor or pharmacist.
To find out where your medication should be stored, you can also visit
our Drug Reference and Interactions database. Enter the name of your
medication in the "Drug Name or Condition" search field to get more
information about storage.
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9. My medication looks different than it did before. Why is that?
Your medication may look different because a different manufacturer
produced it or because it is a different drug, strength, or dosage form
(such as extended vs. immediate release). You can check the label on
your prescription to make sure it is the drug, strength, and dosage you
expected.
Before taking any medication that looks different than you expect,
contact your doctor or Customer Care. Customer Care can connect you with
a pharmacist, if needed.
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10. Is my medication a generic?
Based on your prescription benefit plan, a specific brand-name or
generic medication may have been dispensed. You can check the label on
your prescription to check to see if the drug is "substituted" or
"generic".
You can find out whether your prescription has been filled with a
generic medication by contacting Customer Care or your local pharmacy.
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11. What is the difference between brand and generic medications?
The original developer of the medication generally manufactures the
brand-name product. A manufacturer that did not originally produce the
medication generally produces a generic version. All the active
ingredients in both versions are the same and generics are safe and
effective. However, generic drugs typically cost less than brand-name
drugs. That’s because generic manufacturers do not have the costs
associated with the development of brand-name medications, so they can
produce them for less. Generic medications must meet U.S. Food and Drug
Administration (FDA) guidelines before they can be sold.
CVS Caremark also has an approval process to evaluate manufacturers. All
manufacturers must meet CVS Caremark standards for us to purchase and
dispense their products.
You may also want to consult with your doctor or pharmacist for more
information about a particular drug.
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* WEB AND ACCOUNT SUPPORT
1. How do I contact Web Support?
You can use the Contact Caremark online form.
We support these browsers for desktop and laptop PC users:
* Microsoft Internet Explorer 8.0, 9.0, 10.0 and 11.0
* The two most recent versions of Google Chrome
* The two most recent versions of Mozilla Firefox
We support these browsers for desktop and laptop Mac users:
* The two most recent versions of Apple Safari
* The two most recent versions of Google Chrome
* The two most recent versions of Mozilla Firefox
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2. Why can't I see my statement of coverage or forms on the website?
If you are having trouble viewing PDFs on Caremark.com, you may need to
make sure you've disabled any pop-up blockers. To find out how to
disable pop-up blockers, you can either search Google or go to your
browser's Help section.
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3. I do not want to use the text-to-refill service. How do I stop the text
messages?
Text "Stop" to unsubscribe from the messaging service. You will still be
able to receive updates by email.
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4. Will I be charged an extra fee for ordering my prescriptions by text
message?
No, we don't charge an extra fee. Text messaging rates from your cell
phone company may apply.
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5. When I respond to a refill text, why do I keep getting a message saying
you can't understand my reply?
Your text message is going through an automated system that only
recognizes a few responses: YES to refill, NO to decline the refill,
HELP for more information or STOP to unsubscribe. Don't add any other
words or punctuation.
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6. Where can I find my group code number?
Your group code is located on your prescription member ID card. If you
can't find your card, you may be able to view it online in the My
Account section. Not all benefit plans have this option.
If you do not see the Print My Prescription Benefit Card link and are
not sure of the group code, contact Customer Care.
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7. I lost my member ID card. How do I receive a replacement?
Some members can print their prescription member ID card from a link in
the Profile section. However, not all benefit plans have this option. If
you don't see the Print My Prescription Benefit Card link,
contact Customer Care.
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8. Why do I need to log in to Caremark.com to see the list of pharmacies?
We provide you with a list of local retail pharmacies that are covered
under your prescription benefit plan. In order to find ways to help you
save on your prescription costs we need you to sign in to find your plan
details.
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9. How do I retain the same username and password when my plan changes?
When your plan changes, you have to create a new account. This new
account is your active account and the old one becomes inactive.
You can’t use the same username and password for two different accounts.
You can use your current username and password for your new account, but
you’ll have to first change the username and password for your old
account. If you don't want to keep the old account, you can contact
Caremark and they’ll help you remove it.
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10. How can I get prescription order and account alerts?
To receive alerts and other communications, sign in to Caremark.com and
go to Profile and then choose Communication Preferences.
You can get order and account alerts by text, email, or phone.
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11. How do I sign up for paperless documents?
To update your paperless preferences, sign in to your Caremark.com
account. Go to Profile and choose Communication Preferences. You can
then change your paperless settings.
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* GLOSSARY
1. Acute medications
Medications you take for a short time, like an antibiotic
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2. Brand medications
Medications that are made by only one manufacturer; brand medications
often cost more than generic medications
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3. Coinsurance
A percentage of the cost of the medication that your plan requires you
to pay after you meet any deductible; For example, if your plan requires
you to pay 20% coinsurance and your medication costs $100, you will pay
$20 at the pharmacy.
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4. Copay
A flat amount you pay for your medication regardless of how much the
medication actually costs; For example, a plan might require a $10 copay
for generics and a $25 copay for brands.
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5. Deductible
The amount you pay for prescription medications before your prescription
benefit plan starts to pay; Most plans have an individual deductible
amount and a family deductible amount (usually an annual deductible).
View your Prescription Plan Summary to understand your deductible.
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6. Flexible Spending Account (FSA)
An arrangement through your employer that lets you pay for many
out-of-pocket medical expenses with tax-free dollars. Allowed expenses
include insurance copayments and deductibles, qualified prescription
drugs, insulin, and medical devices.
You decide how much to put in an FSA, up to a limit set by your
employer. You aren't taxed on this money.
If money is left at the end of the year, the employer can offer one of
two options (not both):
* You get 2.5 more months to spend the leftover money
* You can carry over up to $500 to spend the next plan year
Flexible Spending Accounts are sometimes called Flexible Spending
Arrangements.
Source: HealthCare.gov Glossary, 2021.
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7. Formulary
A list of prescription medications covered by your prescription benefit
plan; If a medication is not on the formulary, it isn’t covered under
your plan and you’ll have to pay the entire cost; it may also be called
a drug list.
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8. Generic medications
Medications that can be made by more than one manufacturer because the
patent has expired; Generics have the same active ingredients as brand
medications and are approved by the U.S. Food and Drug Administration
(FDA); Generics are often the lowest-cost medication option.
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9. Health Reimbursement Arrangement (HRA)
Health Reimbursement Arrangements (HRAs) are employer-funded group
health plans from which employees are reimbursed tax-free for qualified
medical expenses up to a fixed dollar amount per year. Unused amounts
may be rolled over for use in subsequent years. The employer funds and
owns the arrangement. Health Reimbursement Arrangements are sometimes
called Health Reimbursement Accounts.
Source: HealthCare.gov Glossary, 2021.
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10. Health Savings Account (HSA)
A type of savings account that lets you set aside money on a pre-tax
basis to pay for qualified medical expenses. By using untaxed dollars in
a Health Savings Account (HSA) to pay for deductibles, copayments,
coinsurance, and some other expenses, you may be able to lower your
overall health care costs. Generally, HSA funds cannot be used to pay
premiums.
While you can use the funds in an HSA at any time to pay for qualified
medical expenses, you can only contribute to an HSA if you have a High
Deductible Health Plan (HDHP) — generally a health plan (including a
Marketplace plan) that only covers preventive services before the
deductible.
Source: HealthCare.gov Glossary, 2021.
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11. High deductible health plan (HDHP)
Type of benefit plan that requires you to pay toward a deductible before
the plan starts covering expenses; Typically, HDHPs offer lower monthly
premiums to offset the higher deductible.
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12. Maximum allowable benefit
The most your plan will cover for medications or services during the
plan year
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13. Out-of-pocket maximum
The maximum amount you will pay out of your pocket before medications or
medical services are covered at 100%. You may view your out of pocket
details in your Prescription Plan Summary or track expenses through your
Financial Summary to learn more.
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14. Pharmacy network
The pharmacies that participate in your benefit plan; If you fill at a
pharmacy that isn’t in the network, you’ll have to pay the entire cost
of your medication.You can find a local participating pharmacy using the
Pharmacy Locator.
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15. Preferred/Non-preferred
In some drug classes, there are multiple medications that treat the same
condition or symptoms – to help control costs, the plan may designate
certain medications as preferred; Preferred medications are typically a
lower-cost option than non-preferred.
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16. Step therapy
Requirement that you try a preferred alternative before certain
higher-cost medications are covered; If you try the preferred medication
and it doesn’t work for you, the higher-cost medication will be covered.
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17. Maintenance medications
Medications you take regularly, such as high blood pressure, high
cholesterol, or diabetes medications; May also be called long-term
medications.
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18. Preventive drug list
List of medications used to treat conditions that could lead to serious
or costly complications if they aren’t managed (like high blood pressure
or high cholesterol) – these medications are covered (often at 100%)
regardless of how much you’ve paid toward your deductible.
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19. Prior authorization
Requirement that your doctor provide more information on why a specific
medication was prescribed for you; The plan reviews this information and
determines whether or not your medication will be covered.
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20. Quantity limit
Limit on the amount of medication the plan will cover; If you continue
to fill prescriptions after the quantity limit is reached, you will have
to pay the entire cost.
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21. Refill limit
The number of 30-day supplies you can fill before you must switch to
90-day supplies through CVS Caremark® Mail Service Pharmacy or another
pharmacy as required by your plan
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22. Specialty medications
Medications that treat complex or chronic conditions like rheumatoid
arthritis (RA), multiple sclerosis (MS) or cancer; Specialty medications
are typically high cost and are often injected or infused. Learn more
about CVS Specialty.
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CONTACT CAREMARK
You may Contact Us directly using our online form. To submit the form, you must
sign in to your account.
You may also call Customer Care at the number listed on your prescription ID
card.
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