Carefirst and cvs

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The drugs are categorized into one of the following tiers and your cost-share is determined by that tier. For information on a particular drug, use the Drug Search tool. Expand All Collapse All. Zero cost-share drugs include preventive drugs, oral chemotherapy drugs, medication assisted treatment drugs and diabetic supplies. Generic drugs are equally safe and effective as brand-name drugs, but generics typically cost significantly less.

Preferred brand drugs are brand-name drugs that may not be available in generic form, but are chosen for their cost effectiveness compared to alternatives. Your cost-share will be more than generics but less than non-preferred brand drugs.

If a generic drug becomes available, the preferred brand drug may be moved to the non-preferred brand category. Non-preferred brand drugs often have a generic or preferred brand drug option where your cost-share will be lower. These drugs may have a lower cost-share than non-preferred specialty drugs. Non-preferred specialty drugs often have a specialty drug option where your cost-share will be lower. This program addresses the unique clinical needs of those taking high-cost specialty drugs for certain diseases like multiple sclerosis and hemophilia.

This program provides enhanced one-on-one support with a registered nurse, hour pharmacist assistance, condition-specific education and counseling and a dedicated clinical team to work with your doctor to help manage specialty drugs. When you are taking multiple drugs to treat a medical condition, it can be overwhelming. The Comprehensive Medication Review program can connect you with a CVS Caremark pharmacist who will review your medications and talk to your doctor about dosages, duration and any other pertinent issues.

The pharmacist will work with your doctor to determine which medications best fit your situation. Medications do not work if they are not taken as prescribed. Pharmacists are alerted to gaps in care and non-adherence and provide in-person one-on-one counseling when the prescription is filled at a CVS pharmacy.

If the prescription is filled through mail order or at other network pharmacies, one-on-one telephonic counseling is offered to help you stay on track. The pharmacist will provide personalized tips and support to help you stay adherent to your medications and identify potential opportunities for you to save money on your prescriptions. To ensure you are receiving the most appropriate medication for your condition s , certain medications have prescription guidelines.

To see whether your drug requires prior authorization, step therapy or quantity limits, use our Drug Search. If you fill a non-preferred brand drug when a generic alternative is available, you will pay the non-preferred brand copay or coinsurance plus the cost difference between the generic and non-preferred brand drug, even if your doctor states Dispense as Written DAW on the prescription.

There is an exception process if you need the brand-name drug to be covered for medical necessity reasons. Your doctor may submit a brand exception request. To view this form, check our Drug Forms. Prior authorization is required before you fill prescriptions for certain drugs. Learn More. We're on a mission to make quality care affordable, easy to use and available to everyone in Maryland, Washington, D.

Learn about who we are and who we advocate for. Discover how we're investing in the health of our communities. Learn how we're working to transform healthcare. Our online resources, tools and support make doing business with CareFirst easy, so you can focus on patient care.

Apply Now. Interested in making a meaningful difference in our community? Explore our career opportunities to find your place with one of the world's most ethical companies.

Search Jobs. Have a question for us? If you are looking to buy or renew a CareFirst plan, please contact us at Have a question about individual or family plans?

Visit our contact us page. Skip Navigation. Login Register. Explore our Insurance Basics pages. Need Insurance? Log In or Register. Find a Doctor.

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In its 79th year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to 3.

Through its 9, retail locations, more than 1, walk-in medical clinics, a leading pharmacy benefits manager with nearly 90 million plan members, a dedicated senior pharmacy care business serving more than one million patients per year, expanding specialty pharmacy services, and a leading stand-alone Medicare Part D prescription drug plan, the company enables people, businesses and communities to manage health in more affordable and effective ways.

This unique integrated model increases access to quality care, delivers better health outcomes and lowers overall health care costs. For mor information on how CVS Health is shaping the future of health, visit their website. Subscribe Unsubscribe. Skip Navigation. Login Register. Our Mail Service Pharmacy is a convenient and economical option that gives you access to: Convenient, dependable delivery service to your home or location of choice at no additional cost.

Refill your prescription online, by phone or by email. Check account balances and make payments by phone. Email notifications of your order status. Various payment options. Do you currently get your prescriptions by mail order? If you get your medications by mail order now, you will need to set up a new mail order account when you move to your new health insurance provider. To ensure you are never without the prescriptions you need, we encourage you to refill your mail order prescription under your current plan before you change plans if available , or ask your provider to provide a one-month prescription to be filled at a local retail pharmacy while your new mail order account is set up.