Prescription Drug Benefits
The Health and Benefit Trust Fund offers prescription drug benefits to eligible participants. Prescription drug benefits include coverage for filling prescriptions at retail pharmacies and a mail-order prescription drug program.
The Prescription Drug Plan is administered by CVS Caremark. You can visit the CVS Caremark website at www.caremark.com.
Find out more about your prescription drug benefits by clicking on the links below:
The Local 94 Health and Benefit Trust Fund offers a Prescription Drug Plan that helps you pay for medication. Eligible participants receive benefits such as coverage for maintenance, or long-term, medications, the use of a mail-order pharmacy and the use of a nation-wide network of retail pharmacies. The Prescription Drug Plan is administered by CVS Caremark.
Eligibility and Enrollment
Membership ID Card
When you become eligible to participate in the Health and Benefit Trust Fund Prescription Drug Plan, you receive a membership card from CVS Caremark. Your card has your member ID, group ID and important contact information. If you do not receive a card from CVS Caremark after becoming eligible or need to print a temporary ID card, visit CVS’s website at www.caremark.com or contact the Fund Office.
The CVS Caremark network has retail pharmacies across the country, which are not solely CVS. Additionally, the CVS Caremark network includes a CVS Caremark Mail Service Pharmacy.
Participants can utilize the retail pharmacy network to fill your short-term prescriptions (up to 30 days). However, a maintenance prescription is typically taken on a regular basis to treat a chronic condition and will exceed two fills. If you exceed two fills on a specific prescription, your third fill must be purchased through the CVS Caremark Mail Service Pharmacy or a retail CVS pharmacy only. If you are using the CVS/Caremark Mail Service Pharmacy you must download and fill out the CVS/Caremark Mail Service Order Form.
Find a Network Pharmacy
To find a CVS Caremark network pharmacy in your area, visit the CVS Caremark website at www.caremark.com. You must first register at the CVS Caremark website in order to use this service.
The Prescription Drug Plan covers many prescription drugs, including brand-name and generic medications. Maintenance drugs, or drugs taken for chronic conditions, are also covered under the Plan.
A complete list of covered prescription drugs is found in the CVS Caremark Formulary. A formulary contains prescription drugs that the Plan Benefit Manager (in this case CVS Caremark) and prescription drug manufacturers have agreed to sell at discounted prices.
- You can view the CVS Caremark formulary at www.caremark.com. Check to see if any medication you currently take is on the formulary. If your medication is not on the formulary, speak with your doctor right away.
Prescription Drug Costs
As a participant in the Prescription Drug Plan, you share the cost of your prescription medications with the Health and Benefit Trust Fund.
When filling a prescription, you pay a copayment, or a small, one-time fee. The amount of your copayment depends on the amount of medication prescribed and whether your prescription is for a generic drug, a brand-name drug found on the formulary or a brand-name drug not found on the formulary.
Generic versus Brand-Name
There is very little difference between generic and brand-name prescription drugs. Drug companies that manufacture brand-name drugs hold a patent for their medications.
When the patent expires, other companies manufacture the same drug, but these are called generic drugs. The FDA makes sure the generic medicine has the same clinical effect and is just as safe as the brand-name product.
Generic drugs cost substantially less to manufacture than brand-name drugs, meaning they cost less for you to purchase.
Ask your doctor if a generic alternative can replace your brand-name prescriptions.
Prescription Drug Claims
Typically, an In-Network provider files your prescription drug claims for you. However, if you have to file your own claim, you can download and fill out the CVS/Caremark Reimbursement Claim Form (PDF). You must file your claim within one year of the date that the charges are incurred.
Visit CVS Caremark’s Member Website
CVS Caremark’s member website lets you order prescriptions online and learn about your medication. The site is available 24/7. At CVS Caremark’s member website you can:
- Order and refill your prescriptions online
- Find a network retail pharmacy
- Learn about different prescription drugs
- Chat with a licensed pharmacist and ask questions
- Look up your prescription drug claim history
To access the site, visit www.caremark.com. To register, use your member ID found on your CVS Caremark ID card.
For more information on how the Prescription Plan works and what CVS Caremark covers contact CVS directly at 888-769-9054 or log onto www.caremark.com. You may also download the SPD for Actives and Retirees in the Commercial Division, Health and Benefit Fund Summary of Material Modifications (SMM) or contact the Fund Office.
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As an Active Member, what is our Medical Coverage?
The Health and Benefit Trust Fund offers medical benefits to active eligible participants. Medical benefits include coverage for preventive care, doctor visits, hospital stays and other medical services. The Health and Benefit Trust Fund shares most of the cost of medical services when you visit in-network providers, meaning you pay less out-of-pocket for your health care. The Medical Plan is administered by Empire BlueCross BlueShield. For more information, go to the Medical Benefits page.