When you enroll in one of the Danone Cigna medical plans, prescription drug coverage is automatically provided through CVS/Caremark. If you enroll in a regional medical plan, prescription drug coverage is available through either Kaiser or SelectHealth. Find out what you will pay for prescription drug coverage under each medical plan option. 
 

NOTE: If the cost of the drug is lower than the generic copay or the minimum brand name copay, you will only pay the cost of the drug. You will never pay more than the full cost of the drug. If you and/or your dependents have Medicare or will become eligible for Medicare in the next 12 months, federal law gives you more choices about your drug coverage.

Key Features of CVS/Caremark

It’s important to understand how the features of the prescription drug benefits work and those that are in place to help you save money on your medications, whether it’s a one-time prescription or an ongoing maintenance medication.

Mandatory Generic Drug Program

Generic medications are a non-brand alternative that are a less costly choice while maintaining the same efficacy. The Food and Drug Administration requires that generic drugs have the same active ingredients and take the same form (for example, pill or liquid) as brand-name drugs. 

As part of the Mandatory Generic Drug Program, your prescription will be filled with the generic equivalent if one is available. Using generics saves you money— some brand-name drugs cost as much as eight times more than the generic option! If a brand name drug is requested when a generic is available, you will pay the applicable copay, plus the difference between the cost of the generic and brand drug.

Mandatory Specialty Pharmacy

If you or one of your dependents take a specialty medication to treat a chronic, high-cost illness, like multiple sclerosis, rheumatoid arthritis, anemia or cancer, you must obtain the medication through CVS/Caremark’s Specialty Pharmacy, which can be reached at 1-866-387-2573.

Specialty Medications with PrudentRx 

If you enroll in the Choice PPO, HDHP Plus, or HDHP Savings plan through Cigna, you can enroll in PrudentRx, a manufacturer copay assistance program for specialty medications. If you are enrolled in the Choice PPO,  PrudentRx will cover all specialty drugs on the plan's formulary and PrudentRx Specialty Drug List at 100% without meeting the deductible for the Choice PPO Plan. If you are enrolled in the HDHP Plus or HDHP Savings plans, PrudentRx will cover all specialty drugs on the plan's formulary and PrudentRx Specialty Drug List at 100% after you've met the deductible. If you do not enroll in PrudentRx, specialty medications will be subject to a 30% coinsurance. PrudentRxcan be reached at 800-578-4403 8 a.m. to 8 p.m., Monday through Friday EST. 

Retail Pharmacy Program

Short-term prescriptions must be filled at one of CVS/Caremark’s network of participating pharmacies. Prescriptions filled at non-participating pharmacies are generally not covered. To locate an in-network pharmacy or reference the 2024 formulary drug list, visit www.caremark.com or call CVS/Caremark at 1-800-556-2581.

Mail-Order/Maintenance Choice Program

If you need long-term or maintenance medications (e.g., those used to treat chronic medical conditions like high blood pressure, diabetes, or asthma), the Mail Order Pharmacy benefit is a convenient option that allows you to receive a 90-day supply of your medication delivered right to your door. 

To participate, fill out the form online at www.caremark.com or mail in the completed CVS/Caremark form along with your 90-day prescription from your doctor. 

You also have the option to use the Maintenance Choice program, which allows you to fill a 90-day prescription at your local CVS Pharmacy, at the same copay as the mail order service. You may want to use Maintenance Choice if you would like the added convenience of being able to pick up your prescriptions on the same day and the opportunity to speak with a CVS pharmacist. 

Important! For all maintenance medications, after the first three fills, you must fill a 90-day supply either at a CVS/Caremark retail pharmacy or through Mail Order. 

After three fills (original and two refills), if you refill for a 30-day supply or go to a non-CVS retail pharmacy your refill will be rejected. You will be responsible for 100% of the full cost for all subsequent fills. To opt out of this program, you can call the CVS customer care phone number at 1-800-556-2581.

Cost Saver Powered By GoodRx 

Automatic discounts are already built into your costs with Cost Saver, powered by GoodRx. The plan does the work to find you the best price, whether it be through the plan or with GoodRx. Then, those savings are passed on directly to you, with no extra effort required.

• Provides you with the best available prices for many commonly prescribed, non-specialty generic drugs.
• Applies your out-of-pocket costs to deductibles and out-of-pocket maximums.
• Coordinates clinical support and adherence programs using integrated data.
• Delivers a seamless experience that avoids wasted time shopping around for the best price.