Prescription Drug Coverage for Purdue Medical Plans

2019 Pharmacy Plan Administered by CVS CareMark

Important Notice from Purdue University about Your Prescription Drug Coverage and Medicare

When you enroll in a Purdue medical plan, you can receive prescription medications through a CVS Caremark participating retail pharmacy or through the CVS Caremark mail order program. To find a list of CVS Caremark participating retail pharmacies, use the Pharmacy Locator.

When using a CVS Caremark participating retail pharmacy, prescription medications are filled for a 30-day supply.  

You will now have two options when you need a to fill a maintenance medication. Maintenance medications are commonly used to treat chronic conditions and taken daily over a long period of time.

CVS maintenance 90-day option – With this option, certain maintenance medications can be filled at any CVS retail pharmacy (including those located inside Target stores) at the same discounted price as mail order. The CVS Caremark extended payment option will not be available at the retail pharmacy.

CVS Caremark mail order – With the mail order you can receive up to a 90-day supply of your medication conveniently delivered through the mail at a discounted price. The CVS Caremark discreet packages are tamper-proof, weather-proof and temperature controlled, so it’s a safe option for you.

Since your prescription will need to be delivered through the mail, you will need to allow time for your medication to arrive. If you have a new medication, you may need to ask your doctor to write two prescriptions — one for a 30-day supply that you can have filled right away at a retail pharmacy and one for a 90-day supply that you can send to the mail order program.

Send your prescription to the mail order pharmacy service with a completed Mail Order Form and your copayment. To know how much copayment to include, call the mail order service for an estimate. You can expect to receive your medication in 7 to 14 days from the date you mail your order. For an additional charge, you can choose next-day or second-day delivery. Refills are even easier. You can either call the toll free number on your prescription label, 866-234-7061, or log on to the CVS Caremark website.

To transfer current retail prescriptions to mail order, log on to the CVS Caremark website and choose the medication(s) you want to transfer. Confirm the prescribing doctor information so that CVS Carmark can contact your doctor about transferring the prescription to a 90-day mail order prescription. Once your doctor approves, you can expect to receive your medication within 7-14 days. Be sure you have enough medication on hand before transferring to mail order.

Copay Installment Program

CVS Caremark offers an option to make installment payments on mailorder. The program allows you to pay for your mail order prescriptions over 90 days. To enroll in the program, go to the CVS Caremark website or call 800-234-7061 for more information. Certain limits apply.

Pharmacy benefit for Purdue Health Plan

  • No deductible applies to prescriptions on the Purdue Health Plan.
  • In addition, preventive generic drugs are covered at 100 percent. Other generics, preferred brand name drugs and non-preferred brand name drugs apply to the out-of-pocket maximum. See the coverage levels below. 

Retail pharmacy benefit:

To fill your prescriptions at participating pharmacies, simply show your prescription card at the pharmacy and pay your percentage of the drug's cost. No deductible applies. You have no paperwork to file; the pharmacy will handle your claim. Your prescription ID card is a combined card with your medical plan ID card.

  • Preventive Generic Drugs - You pay $0
  • Generic Drugs - You pay actual cost up to a $10 maximum
  • Preferred Brand Name Drugs - You pay 30% up to a $100 maximum
  • Non-Preferred Brand Name Drugs - You pay 40% up to a $150 maximum

Mail order or CVS 90-day maintenance pharmacy benefit: 

  • Preventive Generic Drugs - You pay $0
  • Generic Drugs - You pay actual cost up to a $25 maximum
  • Preferred Brand Name Drugs - You pay 30% up to a $250 maximum
  • Non-Preferred Brand Name Drugs - You pay 40% up to a $350 maximum

Pharmacy benefit for Purdue Health Plan Plus HSA 1 and
Purdue Health Plan Plus HSA 2

  • Preventive generic medications are available for no charge during any phase of your insurance.
  • Brand name and non-brand name preventive medications are not subject to your deductible. You will pay only the applicable coinsurance.

Deductible Phase: You pay 100 percent of your medical and prescription drug expenses until you meet your combined medical/prescription annual deductible of:

  • Purdue Health Plan Plus HSA 1: $2,000 employee only or $4,000 employee plus one or more covered family members OR
  • Purdue Health Plan Plus HSA 2: $2,750 employee only or $5,500 employee plus one or more covered family members  

Coinsurance Phase: Once you’ve met your annual deductible, you pay the coinsurance amounts listed below until you reach your combined medical/prescription out-of-pocket maximum of:  

  • Purdue Health Plan Plus HSA 1: $3,750 employee only or $7,500 employee plus one or more covered family members OR
  • Purdue Health Plan Plus HSA 2: $5,250 employee only or $10,500 employee plus one or more covered family members  

100 Percent Coverage Phase: Once you’ve reach your combined out-of-pocket maximum, which includes your deductible, your health plan pays 100 percent of eligible medical and prescription drug expenses for the remainder of the benefit year. 

Retail pharmacy benefit:

  • Preventive Generic Drugs - You pay $0
  • Preventive Preferred Brand Name Drugs - No deductible; you pay 35%
  • Preventive Non-Preferred Brand Name Drugs - No deductible; you pay 55%
  • Generic - You pay deductible, then actual cost up to a $10 maximum
  • Preferred Brand Name Drugs - You pay deductible, then 35%
  • Non-Preferred Brand Name Drugs - You pay deductible, then 55%

Mail order or CVS 90-day maintenance pharmacy benefit:

  • Preventive Generic Drugs - You pay $0
  • Preventive Preferred Brand Name Drugs - No deductible; you pay 25%
  • Preventive Non-Preferred Brand Name Drugs - No deductible; you pay 45%
  • Generic - You pay deductible, then actual cost up to a $25 maximum
  • Preferred Brand Name Drugs - You pay deductible, then 25%
  • Non-Preferred Brand Name Drugs - You pay deductible, then 45%

Drug categories for all three medical plans

To determine pricing and which category a specific medication falls within, check the CVS Caremark pricing tool.

Click links below to see prescription price prior to meeting your deductible. Click links below to see prescription price after meeting your deductible.
Purdue Health Plan
Plus HSA 1
Before deductible is met After deductible has been met
Purdue Health Plan
Plus HSA 2
Before deductible is met After deductible has been met
Purdue Health Plan Before deductible is met
(prescription drugs do not apply to deductible for this plan)
J-1 Visa Before deductible is met
(prescription drugs do not apply to deductible for this plan)

Generic preventive drugs

Generally, preventive drugs are prescribed to prevent the occurrence of a disease in someone who has developed risk factors or to prevent the reoccurrence of a disease from which the individual has recovered. Generic forms of these medications are covered at 100 percent by all Purdue medical plans.

Generic drugs

When a drug company's patent on a particular drug expires, other companies are then free to begin producing the exact same drug, but can't use the original brand name. The other companies refer to the drug by its chemical, or generic, name. Generic drugs contain the exact same active ingredients as the brand name drug and must pass U.S. Food and Drug Administration standards for safety and effectiveness. Generic drugs generally cost 25 percent to 60 percent less than the brand name equivalent. Using generics saves money for you and the medical plan.

Preferred brand name drugs

Drugs on the preferred list are brand names that have been identified as excellent values, both clinically and financially. Before a drug can be designated as a preferred brand name, a committee of independent doctors and pharmacists evaluates the drug to be sure it meets standards for safety, effectiveness, and cost.

View the formulary /preferred quick reference drug list.

View the formulary / preferred full detail drug list.

Non-preferred brand name drugs

Some brand name drugs cost more than others, even though they have the same therapeutic effects as less expensive brand name drugs. These more expensive drugs are on the “non-preferred brand name drug” list.

Specialty drugs

Drugs in this category are typically high cost medications that require special handling, administration or monitoring. These medications require prior authorization and must be ordered through the specialty pharmacy. www.CVSspecialty.com or 1-800-237-2767.


Important Notice from Purdue University about Your Prescription Drug Coverage and Medicare

When you enroll in a Purdue medical plan, you can receive prescription medications through a CVS Caremark participating retail pharmacy or through the CVS Caremark mail order program. To find a list of CVS Caremark participating retail pharmacies, use the Pharmacy Locator.

When using a CVS Caremark participating retail pharmacy, prescription medications are filled for a 30-day supply.  

You will now have two options when you need a to fill a maintenance medication. Maintenance medications are commonly used to treat chroinc conditions and taken daily over a long period of time.

CVS maintenance 90-day option – With this option, certain maintenance medications can be filled at any CVS retail pharmacy (including those located inside Target stores) at the same discounted price as mail order. The CVS Caremark extended payment option will not be available at the retail pharmacy.

CVS Caremark mail order – With the mail order you can receive up to a 90-day supply of your medication conveniently delivered through the mail at a discounted price. The CVS Caremark discreet packages are tamper-proof, weather-proof and temperature controlled, so it’s a safe option for you.

Since your prescription will need to be delivered through the mail, you will need to allow time for your medication to arrive. If you have a new medication, you may need to ask your doctor to write two prescriptions — one for a 30-day supply that you can have filled right away at a retail pharmacy and one for a 90-day supply that you can send to the mail order program.

Send your prescription to the mail order pharmacy service with a completed Mail Order Form and your copayment. To know how much copayment to include, call the mail order service for an estimate. You can expect to receive your medication in 7 to 14 days from the date you mail your order. For an additional charge, you can choose next-day or second-day delivery. Refills are even easier. You can either call the toll free number on your prescription label, 866-234-7061, or log on to the CVS Caremark website.

To transfer current retail prescriptions to mail order, log on to the CVS Caremark website and choose the medication(s) you want to transfer. Confirm the prescribing doctor information so that CVS Carmark can contact your doctor about transferring the prescription to a 90-day mail order prescription. Once your doctor approves, you can expect to receive your medication within 7-14 days. Be sure you have enough medication on hand before transferring to mail order.

Copay Installment Program

CVS Caremark offers an option to make installment payments on mailorder. The program allows you to pay for your mail order prescriptions over 90 days. To enroll in the program, go to the CVS Caremark website or call 800-234-7061 for more information. Certain limits apply.

 

Pharmacy benefit for Purdue Health Plan

  • No deductible applies to prescriptions on the Purdue Health Plan.
  • In addition, preventive generic drugs are covered at 100 percent. Other generics, preferred brand name drugs and non-preferred brand name drugs apply to the out-of-pocket maximum. See the coverage levels below. 

Retail pharmacy benefit:

To fill your prescriptions at participating pharmacies, simply show your prescription card at the pharmacy and pay your percentage of the drug's cost. No deductible applies. You have no paperwork to file; the pharmacy will handle your claim. Your prescription ID card is a combined card with your medical plan ID card.

  • Preventive Generic Drugs - You pay $0
  • Generic Drugs - You pay actual cost up to a $10 maximum
  • Preferred Brand Name Drugs - You pay 30% up to a $100 maximum
  • Non-Preferred Brand Name Drugs - You pay 40% up to a $150 maximum

Mail order or CVS 90-day maintenance pharmacy benefit: 

  • Preventive Generic Drugs - You pay $0
  • Generic Drugs - You pay actual cost up to a $25 maximum
  • Preferred Brand Name Drugs - You pay 30% up to a $250 maximum
  • Non-Preferred Brand Name Drugs - You pay 40% up to a $350 maximum

Pharmacy benefit for Purdue Health Plan Plus HSA 1 and
Purdue Health Plan Plus HSA 2

  • Preventive generic medications are available for no charge during any phase of your insurance.
  • Brand name and non-brand name preventive medications are not subject to your deductible. You will pay only the applicable coinsurance.

Deductible Phase: You pay 100 percent of your medical and prescription drug expenses until you meet your combined medical/prescription annual deductible of:

  • Purdue Health Plan Plus HSA 1: $1,750 employee only or $3,500 employee plus one or more covered family members OR
  • Purdue Health Plan Plus HSA 2: $2,500 employee only or $5,000 employee plus one or more covered family members  

Coinsurance Phase: Once you’ve met your annual deductible, you pay the coinsurance amounts listed below until you reach your combined medical/prescription out-of-pocket maximum of:  

  • Purdue Health Plan Plus HSA 1: $3,500 employee only or $7,000 employee plus one or more covered family members OR
  • Purdue Health Plan Plus HSA 2: $5,000 employee only or $10,000 employee plus one or more covered family members  

100 Percent Coverage Phase: Once you’ve reach your combined out-of-pocket maximum, which includes your deductible, your health plan pays 100 percent of eligible medical and prescription drug expenses for the remainder of the benefit year. 

Retail pharmacy benefit:

  • Preventive Generic Drugs - You pay $0
  • Preventive Preferred Brand Name Drugs - No deductible; you pay 35%
  • Preventive Non-Preferred Brand Name Drugs - No deductible; you pay 55%
  • Generic - You pay deductible, then actual cost up to a $10 maximum
  • Preferred Brand Name Drugs - You pay deductible, then 35%
  • Non-Preferred Brand Name Drugs - You pay deductible, then 55%

Mail order or CVS 90-day maintenance pharmacy benefit:

  • Preventive Generic Drugs - You pay $0
  • Preventive Preferred Brand Name Drugs - No deductible; you pay 25%
  • Preventive Non-Preferred Brand Name Drugs - No deductible; you pay 45%
  • Generic - You pay deductible, then actual cost up to a $25 maximum
  • Preferred Brand Name Drugs - You pay deductible, then 25%
  • Non-Preferred Brand Name Drugs - You pay deductible, then 45%

Drug categories for all three medical plans

To determine pricing and which category a specific medication falls within, check the CVS Caremark pricing tool.

Click links below to see prescription price prior to meeting your deductible. Click links below to see prescription price after meeting your deductible.
Purdue Health Plan
Plus HSA 1
Before deductible is met After deductible has been met
Purdue Health Plan
Plus HSA 2
Before deductible is met After deductible has been met
Purdue Health Plan Before deductible is met
(prescription drugs do not apply to deductible for this plan)
J-1 Visa Before deductible is met
(prescription drugs do not apply to deductible for this plan)

Generic preventive drugs

Generally, preventive drugs are prescribed to prevent the occurrence of a disease in someone who has developed risk factors or to prevent the reoccurrence of a disease from which the individual has recovered. Generic forms of these medications are covered at 100 percent by all Purdue medical plans.

View the generic preventive drug list.

Generic drugs

When a drug company's patent on a particular drug expires, other companies are then free to begin producing the exact same drug, but can't use the original brand name. The other companies refer to the drug by its chemical, or generic, name. Generic drugs contain the exact same active ingredients as the brand name drug and must pass U.S. Food and Drug Administration standards for safety and effectiveness. Generic drugs generally cost 25 percent to 60 percent less than the brand name equivalent. Using generics saves money for you and the medical plan.

Preferred brand name drugs

Drugs on the preferred list are brand names that have been identified as excellent values, both clinically and financially. Before a drug can be designated as a preferred brand name, a committee of independent doctors and pharmacists evaluates the drug to be sure it meets standards for safety, effectiveness, and cost.

View the formulary /preferred brand drug list.

Non-preferred brand name drugs

Some brand name drugs cost more than others, even though they have the same therapeutic effects as less expensive brand name drugs. These more expensive drugs are on the “non-preferred brand name drug” list.

Specialty drugs

Drugs in this category are typically high cost medications that require special handling, administration or monitoring. These medications require prior authorization and must be ordered through the specialty pharmacy. www.CVSspecialty.com or 1-800-237-2767.

View the specialty drug list.

Maintenance drugs

Maintenance medications are commonly used to treat chroinc conditions and taken daily over a long period of time.

View the CVS 90-day maintenance drug list.

Non-covered drugs

Some drugs are not covered. These are often drugs that the U.S. Food and Drug Administration has found to be totally identical to another drug on the market.

Contraceptives

As mandated by the Affordable Care Act, generic contraceptives approved by the Food and Drug Administration will be covered at 100 percent. For information about these, go to the CVS Caremark webpage.

CVS caremark

www.caremark.com
Caremark customer service
1-866-234-7061

Purdue University, 610 Purdue Mall, West Lafayette, IN 47907, (765) 494-4600

2015 Purdue University | An equal access/equal opportunity university | Copyright Complaints | HR Communications

If you have trouble accessing this page because of a disability, please contact HR Communications at hrcomm@purdue.edu.