Prescription Drug Coverage for Purdue Medical Plans
When you enroll in a Purdue medical plan, you have two options to receive prescription medications:
1) through a CVS Caremark participating retail pharmacy (30-day supply)
To find a list of CVS Caremark participating retail pharmacies, use the Pharmacy Locator.
2) through the CVS Caremark mail order program (90-day supply).
Additionally, Purdue partners with Rx Savings Solutions, which offers ways to save on prescription costs.
| 2024 Prescription Drug Coverage* | Premier, Standard & Limited CDHPs | ||
| Retail (30-day supply)* | Mail Order (90-day supply) | ||
| Generic | Preventive | 100% coverage | 100% coverage |
| Non-preventive | Deductible, then actual cost up max of $10 | Deductible, then actual cost up max of $20 | |
| Preferred Brand Name | Preventive | No deductible, 35% to max of $50 | No deductible, 35% to max of $100 |
| Non-preventive | Deductible, then 35% to max of $50 | Deductible, then 35% to max of $100 | |
| Non-Preferred Brand Name | Preventive | No deductible, 50% up to max of $75 | No deductible, 50% up to max of $150 |
| Non-preventive | Deductible, then 50% up to max of $75 | Deductible, then 50% up to max of $150 | |
| Specialty Rx | Deductible then 55% up to max of $250 max | Deductible then 55% up to max of $250 max |
90-day supply of prescriptions available at CVS retail pharmacies, based on mail-order pricing.*
2024 Medical Plan coverage - Pharmacy and Labs
*There are definitions of 'Drug Coverage Types' under the web section Drug Types.
To determine pricing and which category a specific medication falls within, utilize the CVS Caremark pricing tool.
| Click links below to see prescription price prior to meeting your deductible. | |
| Premier Plan CDHP | Before deductible is met |
| Standard Plan CDHP | Before deductible is met |
| Limited Plan CDHP | Before deductible is met |
| J-1 Visa | Before deductible is met (prescription drugs do not apply to deductible for this plan) |
The Value Formulary Quick Reference List is not an all-inclusive list but represents a summary of prescribed medications within selective therapeutic categories.
The Value Formulary is a useful information and resource tool.
With the mail order option, 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 provider information so that CVS Caremark can contact them to request a transfer to a 90-day mail order prescription. Once your provider approves, you can expect to receive your medication within 7 to 14 days. Be sure you have enough medication on hand before transferring to mail order.
CVS Caremark offers an option to make installment payments on prescriptions received via mail order. 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.
Visit the CVS Caremark website or the CVS Caremark mobile app for additional resources.
CVS Customer Caremark customer service can be reached at 866-234-7061. You also may contact CVS Caremark directly using their online form. To submit the form, you must sign in to your account.
Additionally, the CVS Caremark Help Center is available to help answer many questions.
This notice has information about your Purdue prescription coverage and your options under Medicare’s prescription drug coverage.
Rx Savings Solutions is a FREE, confidential program that works in conjunction with Purdue’s prescription coverage to provide transparency into prescription costs and options and offers personalized prescription guidance for every member on your health plan. As part of your Purdue health plan, your Rx Savings Solutions account is ready to go – all you need to do is activate your account. Visit myrxss.com to activate it today and start saving. More information about Rx Savings Solutions is available here.
Drug Types
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.
When a drug company's patent on a particular drug expires, other companies can 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.
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.
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.
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. Purdue partners with Archimedes to administer specialty medications. The specialty pharmacy that will actually be providing the medications to you is called AcariaHealth. Your medication will be sent to you by home delivery with 24/7 access to pharmacists and nurses. Oftentimes, there are copay assistance programs* that are available from drug manufacturers to help cover the cost of these medications, and Archimedes will help find these and other ways to ensure you get the medications you need at the lowest costs possible.
Questions
Contact Archimedes via email at memberservices@archimedesrx.com or by calling 888-318-0445.
Contact the specialty pharmacy, AcariaHealth, at 844-484-6926.
*Copay assistance program discounts do not apply to the deductible and out of pocket on any of the Purdue University health plans.