TOLL FREE - 800-294-6324
TDD TOLL FREE - 800-863-5488
Caremark Connect Specialty Pharmacy TOLL FREE - 800-237-2767
"LET'S TALK PREVENTION" is a valuable resource outlining all of the various benefits available to members through Caremark at NO COST TO YOU! These benefits are part of the Affordable Care Act (ACA) and are provided through your SEHP medical plan.
Prescription drug coverage through Caremark is included with Plans A, C, J, N and Q. While the Preferred Drug List (PDL) is the same for all plans, the amount you pay will vary depending on the plan you select as explained below.
Note: When using the drug cost links, it is recommended the search be performed using a 30-day supply of your medication. If you are already an active SEHP participant, you should log on to Caremark.com and perform your search. The Caremark.com site will provide you with a cost estimate based upon your actual health plan enrollment.
Before your next medical appointment, it is suggested that you print out the Preferred Drug List (PDL) from the website and take it with you so you can discuss your prescription drug options with your health care provider. The Caremark plan is designed
to encourage you and your health care provider to choose the most cost-effective and clinically-effective medications available. The PDL is available in the Plan documents below or www.caremark.com. You
can also call Caremark at 800-294-6324 for help finding a preferred drug.
Home delivery is available through Caremark and reorders are processed in as little as five to seven days. To place an initial order or reorder by phone, call 1-800-294-6324 or e-mail online@caremark.com.
Specialty and biotech drugs are designed for difficult conditions that don’t respond to traditional therapy. A complete list of Specialty Drugs is available in the plan documents below or at www.Caremark.com. These drugs are available only through the Caremark Connect Specialty Pharmacy. Contact Caremark Connect at 1-800-237-2767. A Caremark representative will coordinate patient care with the provider and arrange for medication delivery.
Formulary Exclusions Requiring Prior Authorization List - Effective Jan 1, 2021
Preferred Drug List - Effective Jan 1, 2021
Advanced Control Specialty Formulary - Effective Jan 1, 2021
Discount Tier - Effective Jan 1, 2021
Formulary Drug Table - Effective Jan 1, 2021
Injectable and Infused Drugs Covered under the Pharmacy Benefit – Effective January 1, 2021
NonCovered Injectables - Effective Jan 1, 2021
Oral Oncology Drug List - Effective Jan 1, 2021
Special Case Drug List - Effective Jan 1, 2021
Formulary Exclusions Requiring Prior Authorization List - Effective July 1, 2020
Formulary Exclusions Requiring Prior Authorization List - Effective Oct 1, 2020
Preferred Drug List - Effective July 1, 2020
Preferred Drug List - Effective Oct 1, 2020
Advanced Control Specialty Formulary - Effective July 1, 2020
Advanced Control Specialty Formulary - Effective Oct 1, 2020
Discount Tier - Effective July 1, 2020
Formulary Drug Table - Effective July 1, 2020
Injectable and Infused Drugs Covered under the Pharmacy Benefit - Effective July 1, 2020
Injectable and Infused Drugs Covered under the Pharmacy Benefit - Effective Oct 1, 2020
NonCovered Injectables - Effective July 1, 2020
Oral Oncology Drug List - Effective July 1, 2020
Special Case Drug List - Effective July 1, 2020