Department of Management Services

Frequently Asked Questions - Prescription Drug Plan

CVS Caremark is the Prescription Drug Plan administrator. The FAQs below will help you with questions you have concerning CVS Caremark.


  1. What are compounded medications and what does my prescription drug plan cover?

    Compound medications combine, mix, or alter the ingredients of one or more drugs or products to create another drug or product. Compounded medications can contain substances that have not been rigorously tested for safety or effectiveness. Additionally, not all compounded medications are approved by the U.S. Food and Drug Administration for the prescribed route of administration or the ingredients they contain. 

    The Prescription Drug Plan only covers the federal legend drug ingredient of a compounded medication when all of the following criteria are satisfied:

    1. The compounded medication is not used in place of a commercially available federal legend drug in the same strength and formulation unless medically necessary;
    2. The compounded medication is specifically produced for use by a covered person to treat a covered condition;
    3. The compounded medication including all sterile compounded products is made in compliance with Chapter 465, Florida Statutes.

    Additionally:

    1. Over-the-counter (OTC) products and bulk powders, bulk chemicals, and proprietary bases used in compounded medications are not covered; and,
    2. Reconstitution of oral powders is not considered compounding. The compounding pharmacist must bill the NDC of the product used in the quantity of final reconstituted volume.   

    To ensure you receive the best value possible and do not incur any unnecessary costs, please speak with your healthcare provider to get a prescription for an FDA-approved medication that may be used to treat your condition.

  2. What is "90-days maintenance at retail"?

    Buy two months, get one month free! Visit a participating 90-day maintenance retail pharmacy or use mail order to take advantage of these cost savings. Purchase a 90-day supply of the maintenance medications you take to treat chronic or long-term conditions, such as high blood pressure, high cholesterol, heart disease, asthma and diabetes.

    • If you have a maintenance medication prescription for up to a 90-day supply, you may have it filled one of the three ways:
      • Through the CVS Caremark Mail Service Pharmacy;
      • At a CVS retail pharmacy; or 
      • At any retail pharmacy participating in the new 90-day maintenance retail network established specifically for the State of Florida. The pharmacies in this network may or may not be in the regular 30-day retail network. Visit caremark.com or call 888-766-5490 to find out if your retail pharmacy is choosing to participate in the 90-day maintenance at retail network.
    • Copays for a prescription fill at a participating 90-day maintenance at retail pharmacy are the same as for mail order: $14 for generic drugs, $60 for preferred brand drugs, and $100 for non-preferred brand drugs.
  3. What if I go to the pharmacy without my CVS Caremark ID card?

    You can download CVS Caremark's free smartphone app to use your ID card or tell the pharmacist that your prescription drug plan uses CVS Caremark. The pharmacist can call CVS Caremark to verify your coverage and fill the prescription.

  4. I have individual coverage and I am expecting a baby. When should I add my baby?

    You have 60 days from the birth of the child to enroll in family coverage. The effective date of coverage will be retroactive to the beginning of the month in which the child is born and premiums will be due accordingly.

  5. What happens if I use an out-of-network pharmacy, such as Walgreens?

    If you're in the State Employees' PPO Plan, you may file a claim and be reimbursed for the out-of-network provider benefit, as defined in the Benefit Document. 

    If you are an HMO member, you only have access to network prescription drug benefits, so you would pay the entire cost of the medication out of pocket. 

  6. If I terminate my employment, can I keep my benefits?

    Yes. You may continue some benefits under COBRA. COBRA is a federal law that allows you and your covered family members to continue health, dental and vision coverage for up to 18 months if you are enrolled at the time of termination, and possibly longer under certain circumstances. To continue other supplemental plans, you must contact each supplemental insurance company for the continuation forms.

  7. What if I have manufacturers' discount cards or coupons?

    You cannot use discount cards or coupons with the State Employees' Prescription Drug Plan. 

  8. What if I cannot afford to pay the entire mail-order copay upfront for a 90-day prescription?

    CVS Caremark offers a payment plan option using a debit or credit card. You may pay three monthly installments for a prescription with no interest or service fees. Call CVS Caremark Member Services toll-free at 1-888-766-5490 for more information.

  9. How should my provider write my mail-order prescription?

    Ask your provider to write your prescription for up to a 90-day supply with refills for up to a year, when appropriate. If your provider writes the prescription for a 30-day supply, you must still pay the standard mail order copay. 

    The actual quantity and/or days' supply may vary for each drug. Your provider's instructions on how to take the medication, state and federal dispensing guidelines or how the medication is packaged may impact the quantity and/or days' supply you can receive. 

  10. Can CVS Caremark transfer my prescriptions from a retail pharmacy to the CVS Caremark mail-order pharmacy?

    Yes. For many existing retail prescriptions, you can log in at the Caremark.com or call CVS Caremark Member Services at 1-888-766-5490 to request a new mail order prescription from your physician. Log in at Caremark.com to take advantage of mail order savings opportunities and lower-cost medication alternatives. 

  11. Which medications am I required to fill through mail-order?

    If you are enrolled in the PPO Plan, you must fill your maintenance medications through the mail-order pharmacy or a participating 90-day retail pharmacy after three fills at a 30-day retail pharmacy. Maintenance medications (Adobe PDF Document) are typically used to treat chronic conditions that require regular or on-going use of medicines (e.g. hypertension, diabetes, high cholesterol, asthma). 

    HMO members are not required, but are encouraged, to use mail order because of the cost savings and convenience. 

  12. What are examples of medications that do not need to be filled through mail-order?

    Acute medications taken for a limited time for a short-term condition, such as antibiotics for a sinus infection, ear infection, strep throat, etc. For these, go to your local network 30-day retail pharmacy.

  13. How long does it take to get my medications when I use mail-order?

    For first-time mail-order prescriptions, your medication will usually be delivered within eight days after CVS Caremark receives your complete and accurate prescription. If you are requesting a mail order refill, please be sure to have at least a 14-day supply on hand when ordering. Your prescription is eligible for a refill when 75 percent should have been used if taken as prescribed. If you request a refill too soon, your prescription may be returned to you.

    Refills are usually delivered within three to five days after CVS Caremark receives your request. 

    When it is time to reorder, log into caremark.com and select the medication to refill or set up the ReadyFill at Mail ™

    The most up-to-date information on your refill is available online. 

    Certain medications, including drugs prescribed for narcolepsy, attention deficit disorder, and pain management, require a signature upon delivery. 

  14. How are medications shipped?

    Most medications are shipped via the U.S. Postal Service at no cost to you. Medications containing certain controlled substances are shipped United Parcel Service (UPS). If necessary, you can request express shipping for an additional fee. Shipment of some medications must be scheduled and delivered to a physical address (not a post office box). Generally, these medications require additional packaging, such as cold packs, and will be shipped for delivery within one to two days. 

  15. How do I get started with the CVS Mail Service Pharmacy?

    Ask your provider to write a prescription for up to a 90-day supply, and have it sent to CVS Caremark one of three ways:

    • Mail your prescription and a completed mail order form (Adobe PDF Document 512.62 KB) to the CVS Caremark.
    • Ask your provider to call in your 90-day prescription at 888-766-5490.
    • Ask CVS Caremark to transfer your prescription for you by calling Customer Care at 888-766-5490. 
      • To order additional forms and envelopes, visit caremark.com or call Member Services toll-free at 888-766-5490. Have your member ID number available.

    If you are a member of the State Employees' PPO Plan, you must use the mail order pharmacy or a participating 90-day retail pharmacy for maintenance medications (Adobe PDF Document) after filling the prescription three times at a 30-day retail pharmacy. If you continue to use a retail pharmacy after the third fill, you will pay for the full cost of the medication.
    Please call CVS Caremark Member Services toll-free at 888-766-5490 if you are currently receiving assistance from the Ryan White HIV/AIDS Program (provided by the federal HIV/AIDS Treatment Extension Act of 2009) Florida Medicaid, use V.A. facilities/pharmacies, or live in facility that does not allow medication from the outside, to avoid any inconvenience or interruption of the benefits provided through these programs. 

  16. Is there a service that allows for automatic refills through mail order so I do not have to remember to order my refills?

    Yes, with ReadyFill at Mail™ you can request automatic refills of certain medications on the appropriate refill date. You may also request a new prescription following the last refill after you have taken the medication for a minimum of 30 days. 

    Notifications of refills come in time to allow you to cancel the refill if you choose. 

    Call CVS Caremark Member Services toll-free at 888-766-5490 for more information. 

  17. How do I know whether my medication is covered or if there is a generic equivalent?

    Current members may log into caremark.com to find coverage and pricing details and to find out if medication has a less expensive generic equivalent. Members may also call CVS Caremark Member Services 24/7 toll-free at 888-766-5490.
    Not yet a member? Visit http://info.caremark.com/sofrxplan.

  18. What are the different payment methods accepted by the mail-order pharmacy?

    You can pay by Electronic check, BillMeLater, Credit or Debit (VISA, MasterCard, Discover or American Express) and check or money order can all be used for payment at mail order.  

  19. What if I don't want generic substitutions for my prescription?

    If you request a preferred-brand drug when a generic is available, you must pay the difference between the two, plus the appropriate brand copayment or coinsurance. If your provider writes on the prescription that the preferred-brand drug is medically necessary or "dispense as written" and the reason, you pay only the appropriate brand copayment or coinsurance. 

  20. When my provider faxes a prescription to the mail-order pharmacy, what happens?

    CVS Caremark makes sure the prescription is coming from a secure fax machine associated with a prescriber listed in CVS Caremark's database. A secure fax machine is restricted from public access and is generally within a controlled area in the provider's office. 

    If CVS Caremark cannot determine the security of the fax line, or if the incoming fax number cannot be matched against a prescriber in CVS Caremark's database, CVS Caremark will contact the provider's office to verify your prescription. 

    If the prescription is verified, CVS Caremark processes the prescription. 

    CVS Caremark will contact you if the prescription cannot be verified by your provider. After two unsuccessful attempts to contact you, CVS Caremark will send you a notification stating that your prescription could not be filled due to lack of verification from your provider.