January 2014
Operating Engineers (Local 12) Health & Welfare Fund Prescription Drug Plan Preferred Brand, Non-Preferred Brand and Generic Drug List This summary prescription drug list is intended as an aid to members and health care providers to minimize member copayments under the Operating Engineers Health & Welfare Fund prescription drug plan administered by CVS Caremark. This is only a summary of some of the more commonly prescribed medications showing Non-Preferred Brand drugs (highest copay), the comparable Preferred Brand drugs (lower co-pay) and the generic equivalents (lowest co-pay). Generic drugs should be considered the first line of prescribing. If there is no generic available, there often are more than one brand-name medications to treat a condition. These Preferred Brand-Name medicines are listed to help identify products that are clinically appropriate and cost-effective. This is not an all-inclusive list. A complete list of Preferred Brand drugs can be obtained by logging into www.caremark.com. In this list, Brand-Name medications are shown in CAPS and generic products in lowercase italics.
PLAN MEMBER Ask your doctor to consider prescribing generic drugs whenever possible. If you request a brand-name drug for which a generic drug is available, you will have to pay the appropriate co-pay plus 50% of the difference in price between the brand-name drug and the generic drug. If there is no generic available for a specific medication, ask your doctor to consider a Preferred Brand drug from this list, when medically appropriate, as opposed to a Non-Preferred Brand drug. Take this list along when you or a covered family member sees a doctor. The co-pays under your prescription drug benefit plan are as follows: Drug Type
Retail Pharmacy (Up to 30-day supply)
Mail Pharmacy (Up to 90-day supply)
Tier 1: Generic
$10
$25
Tier 2: Preferred Brand
$25
$62.50
Tier 3: Non-Preferred Brand
$40
$100
Please note:
•
Generics should be considered the first line of prescribing.
•
This drug list represents a summary of prescription coverage. It is not all-inclusive and does not guarantee coverage.
•
Unless specifically indicated, drug list products will include all dosage forms.
•
Log in to www.caremark.com to check coverage and copay information for a specific medicine.
PREFERRED BRAND AND GENERIC ALTERNATIVES LIST Non-Preferred Brand Drugs
Preferred Brand and Generic Alternatives*
Non-Preferred Brand Drugs
Preferred Brand and Generic Alternatives*
ACTOS
pioglitazone
ALVESCO
ADVICOR
atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin, CRESTOR, SIMCOR, VYTORIN
ASMANEX, FLOVENT DISKUS, FLOVENT HFA, PULMICORT FLEXHALER, QVAR
ANDROGEL
ANDRODERM, AXIRON, FORTESTA
AEROSPAN
ASMANEX, FLOVENT DISKUS, FLOVENT HFA, PULMICORT FLEXHALER, QVAR
ANGELIQ
estradiol-norethindrone, PREMPHASE, PREMPRO
ARMOUR THYROID
levothyroxine, SYNTHROID
ALORA
estradiol, DIVIGEL, EVAMIST, MINIVELLE, VIVELLE-DOT
ARTHROTEC
diclofenac sodium-misoprostol, CELEBREX, VIMOVO
ASACOL HD
balsalazide, sulfasalazine, sulfasalazine delayed-rel, APRISO, LIALDA, PENTASA
ALTOPREV
atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin, CRESTOR, SIMCOR, VYTORIN
Your specific prescription benefit plan design may not cover certain products or categories, regardless of their appearance in this document. For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative.
Non-Preferred Brand Drugs
Preferred Brand and Generic Alternatives*
Non-Preferred Brand Drugs
Preferred Brand and Generic Alternatives*
ASCENSIA STRIPS AND KITS
ACCU-CHEK STRIPS AND KITS ONETOUCH STRIPS AND KITS **
ENABLEX
oxybutynin ext-rel, tolterodine, trospium, trospium ext-rel, GELNIQUE, VESICARE
ATACAND, ATACAND HCT
candesartan, candesartan-hydrochlorothiazide, eprosartan, irbesartan, irbesartan-hydrochlorothiazide, losartan, losartan-hydrochlorothiazide, valsartan-hydrochlorothiazide, BENICAR, BENICAR HCT, DIOVAN, MICARDIS, MICARDIS HCT
ENJUVIA
estradiol, estropipate, PREMARIN
ESTRASORB
estradiol, DIVIGEL, EVAMIST, MINIVELLE, VIVELLE-DOT
ESTRING
ESTRACE CREAM, PREMARIN CREAM, VAGIFEM
ATROVENT HFA
SPIRIVA
ESTROGEL
AUVI-Q
EPIPEN, EPIPEN JR
estradiol, DIVIGEL, EVAMIST, MINIVELLE, VIVELLE-DOT
AXERT
naratriptan, rizatriptan, sumatriptan tablet, zolmitriptan, RELPAX, ZOMIG NASAL SPRAY
EUFLEXXA
GEL-ONE, HYALGAN, ORTHOVISC
FEMRING
ESTRACE CREAM, PREMARIN CREAM, VAGIFEM
AZELEX
erythromycin solution
FEMTRACE
estradiol, estropipate, PREMARIN
BECONASE AQ
flunisolide, fluticasone, triamcinolone, NASONEX
FENOGLIDE
fenofibrate, fenofibric acid, ANTARA, LIPOFEN
BENZAC AC, BENZAC W
adapalene, clindamycin solution, clindamycin-benzoyl peroxide, erythromycin solution, erythromycin-benzoyl peroxide, tretinoin, ACANYA, ATRALIN, BENZACLIN, DIFFERIN, EPIDUO, RETIN-A MICRO, TAZORAC
FETZIMA
venlafaxine, venlafaxine ext-rel, CYMBALTA, PRISTIQ
FIRST TESTOSTERONE
ANDRODERM, AXIRON, FORTESTA
FLECTOR
diclofenac, meloxicam, naproxen
adapalene, clindamycin solution, clindamycin-benzoyl peroxide, erythromycin solution, erythromycin-benzoyl peroxide, tretinoin, ACANYA, ATRALIN, BENZACLIN, DIFFERIN, EPIDUO, RETIN-A MICRO, TAZORAC
FORTAMET
metformin, metformin ext-rel
FOSAMAX PLUS D
alendronate, ibandronate, ACTONEL, ATELVIA
FREESTYLE STRIPS AND KITS
ACCU-CHEK STRIPS AND KITS **, ONETOUCH STRIPS AND KITS **
adapalene, clindamycin solution, clindamycin-benzoyl peroxide, erythromycin solution, erythromycin-benzoyl peroxide, tretinoin, ACANYA, ATRALIN, BENZACLIN, DIFFERIN, EPIDUO, RETIN-A MICRO, TAZORAC
FROVA
naratriptan, rizatriptan, sumatriptan tablet, zolmitriptan, RELPAX, ZOMIG NASAL SPRAY
GENOTROPIN
HUMATROPE, NORDITROPIN
GLUMETZA
metformin, metformin ext-rel
ACCU-CHEK STRIPS AND KITS **, ONETOUCH STRIPS AND KITS **
HUMALOG
APIDRA, NOVOLOG
HUMALOG MIX 50/50
NOVOLOG MIX 70/30
HUMALOG MIX 75/25
NOVOLOG MIX 70/30
HUMULIN
NOVOLIN
INNOPRAN XL
atenolol, carvedilol, metoprolol, metoprolol succinate ext-rel, nadolol, propranolol, propranolol ext-rel, BYSTOLIC, COREG CR
BENZAGEL
BENZIQ
BREEZE 2 STRIPS AND KITS
**,
BREO ELLIPTA
ADVAIR, SYMBICORT
CARDURA XL
alfuzosin ext-rel, doxazosin, tamsulosin, terazosin, RAPAFLO
CENESTIN
estradiol, estropipate, PREMARIN
CLINDAGEL
erythromycin solution
COMBIVENT
COMBIVENT RESPIMAT
INTERMEZZO
zolpidem, zolpidem ext-rel
CONTOUR NEXT STRIPS AND KITS
ACCU-CHEK STRIPS AND KITS **, ONETOUCH STRIPS AND KITS **
ISTALOL
timolol maleate solution, BETIMOL
CONTOUR STRIPS AND KITS
ACCU-CHEK STRIPS AND KITS **, ONETOUCH STRIPS AND KITS **
JALYN
finasteride or AVODART WITH alfuzosin ext-rel, doxazosin, tamsulosin, terazosin or RAPAFLO
DELZICOL
balsalazide, sulfasalazine, sulfasalazine delayed-rel, APRISO, LIALDA, PENTASA
KAZANO
JANUMET, JANUMET XR, JENTADUETO
KOMBIGLYZE XR
JANUMET, JANUMET XR, JENTADUETO
LASTACAFT
azelastine, cromolyn sodium, PATADAY, PATANOL
LESCOL XL
atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin, CRESTOR, SIMCOR, VYTORIN
LIPITOR
atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin, CRESTOR, SIMCOR, VYTORIN
LIPTRUZET
atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin, CRESTOR, SIMCOR, VYTORIN
LIVALO
atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin, CRESTOR, SIMCOR, VYTORIN
LUMIGAN
latanoprost, travoprost, TRAVATAN Z, ZIOPTAN
LUNESTA
zolpidem, zolpidem ext-rel
MENEST
estradiol, estropipate, PREMARIN
MENOSTAR
estradiol, DIVIGEL, EVAMIST, MINIVELLE, VIVELLE-DOT
NESINA
JANUVIA, TRADJENTA
DETROL LA
oxybutynin ext-rel, tolterodine, trospium, trospium ext-rel, GELNIQUE, VESICARE
DIOVAN HCT
candesartan-hydrochlorothiazide, irbesartan-hydrochlorothiazide, losartan-hydrochlorothiazide, valsartan-hydrochlorothiazide, BENICAR HCT, MICARDIS HCT
DORAL
zolpidem, zolpidem ext-rel
DUEXIS
diclofenac sodium-misoprostol, VIMOVO
DYMISTA
flunisolide, fluticasone, triamcinolone, or NASONEX WITH azelastine, ASTEPRO or PATANASE
EDARBI, EDARBYCLOR
EDLUAR
candesartan, candesartan-hydrochlorothiazide, eprosartan, irbesartan, irbesartan-hydrochlorothiazide, losartan, losartan-hydrochlorothiazide, valsartan-hydrochlorothiazide, BENICAR, BENICAR HCT, DIOVAN, MICARDIS, MICARDIS HCT zolpidem, zolpidem ext-rel
Your specific prescription benefit plan design may not cover certain products or categories, regardless of their appearance in this document. For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative.
Non-Preferred Brand Drugs
Preferred Brand and Generic Alternatives*
Non-Preferred Brand Drugs
Preferred Brand and Generic Alternatives*
NITROMIST
nitroglycerin sublingual spray, NITROLINGUAL, NITROSTAT
STRIANT
ANDRODERM, AXIRON, FORTESTA
NUTROPIN, NUTROPIN AQ
HUMATROPE, NORDITROPIN
SUBOXONE FILM
buprenorphine-naloxone sublingual tablet, ZUBSOLV
SUPARTZ
GEL-ONE, HYALGAN, ORTHOVISC
OLUX-E
clobetasol propionate foam, CLOBEX SPRAY
OMNARIS
flunisolide, fluticasone, triamcinolone, NASONEX
SURE-TEST STRIPS AND KITS
ACCU-CHEK STRIPS AND KITS **, ONETOUCH STRIPS AND KITS **
OMNITROPE
HUMATROPE, NORDITROPIN
SYNVISC, SYNVISC-ONE
GEL-ONE, HYALGAN, ORTHOVISC
ONGLYZA
JANUVIA, TRADJENTA
TESTIM
ANDRODERM, AXIRON, FORTESTA
OSENI
JANUMET, JANUMET XR, JENTADUETO
TEVETEN, TEVETEN HCT
OXYTROL
oxybutynin ext-rel, tolterodine, trospium, trospium ext-rel, GELNIQUE, VESICARE
PANCREAZE
CREON, ULTRESA, VIOKACE, ZENPEP
candesartan, candesartan-hydrochlorothiazide, eprosartan, irbesartan, irbesartan-hydrochlorothiazide, losartan, losartan-hydrochlorothiazide, valsartan-hydrochlorothiazide, BENICAR, BENICAR HCT, DIOVAN, MICARDIS, MICARDIS HCT
PERTZYE
CREON, ULTRESA, VIOKACE, ZENPEP
TEV-TROPIN
HUMATROPE, NORDITROPIN
PEXEVA
citalopram, escitalopram, fluoxetine, paroxetine, paroxetine ext-rel, sertraline, VIIBRYD
TOVIAZ
oxybutynin ext-rel, tolterodine, trospium, trospium ext-rel, GELNIQUE, VESICARE
PLAVIX
clopidogrel, BRILINTA, EFFIENT
TRICOR
fenofibrate, fenofibric acid, ANTARA, LIPOFEN
PRECISION XTRA STRIPS AND KITS
ACCU-CHEK STRIPS AND KITS **, ONETOUCH STRIPS AND KITS **
TRIGLIDE
fenofibrate, fenofibric acid, ANTARA, LIPOFEN
TRILIPIX
fenofibrate, fenofibric acid, ANTARA, LIPOFEN
PRED MILD
dexamethasone, DUREZOL, LOTEMAX
TRUE CARE STRIPS AND KITS
PREFERAOB
generic prenatal vitamins, CITRANATAL
ACCU-CHEK STRIPS AND KITS **, ONETOUCH STRIPS AND KITS **
PREFEST
estradiol-norethindrone, PREMPHASE, PREMPRO
TRUETEST STRIPS AND KITS
PRENATAL PLUS
generic prenatal vitamins, CITRANATAL
ACCU-CHEK STRIPS AND KITS **, ONETOUCH STRIPS AND KITS **
PREVACID
lansoprazole, omeprazole, omeprazole-sodium bicarbonate capsule, pantoprazole, DEXILANT, NEXIUM
TRUETRACK STRIPS AND KITS
ACCU-CHEK STRIPS AND KITS **, ONETOUCH STRIPS AND KITS **
TUDORZA
SPIRIVA
TWYNSTA
AZOR, EXFORGE
VALTREX
acyclovir, valacyclovir
VANOS
clobetasol
VASCEPA
LOVAZA
VENTOLIN HFA
PROAIR HFA, PROVENTIL HFA
VERAMYST
flunisolide, fluticasone, triamcinolone, NASONEX
VITAFOL-ONE
generic prenatal vitamins, CITRANATAL
XOPENEX HFA
PROAIR HFA, PROVENTIL HFA
ZETONNA
flunisolide, fluticasone, triamcinolone, NASONEX
ZYFLO, ZYFLO CR
montelukast, zafirlukast
PROTONIX
lansoprazole, omeprazole, omeprazole-sodium bicarbonate capsule, pantoprazole, DEXILANT, NEXIUM
QNASL
flunisolide, fluticasone, triamcinolone, NASONEX
RAYOS
dexamethasone, methylprednisolone, prednisone
RELION INSULIN
NOVOLIN INSULIN
RHINOCORT AQUA
flunisolide, fluticasone, triamcinolone, NASONEX
RIOMET
metformin, metformin ext-rel
ROZEREM
zolpidem, zolpidem ext-rel
SAIZEN
HUMATROPE, NORDITROPIN
SANCTURA XR
oxybutynin ext-rel, tolterodine, trospium, trospium ext-rel, GELNIQUE, VESICARE
SKELID
alendronate, ACTONEL
PREFERRED BRAND AND GENERIC PRODUCTS IN ALPHABETICAL ORDER A ABILIFY ACANYA ACCU-CHEK STRIPS AND KITS ** ACTONEL acyclovir adapalene ADVAIR AGGRENOX albuterol alendronate alfuzosin ext-rel allopurinol
ALPHAGAN P ALREX amantadine AMITIZA amlodipine amlodipine-atorvastatin amoxicillin amoxicillin-clavulanate AMTURNIDE ANDRODERM ANTARA APIDRA APRISO ARCAPTA ASMANEX
ASTEPRO ATELVIA atenolol atorvastatin ATRALIN AVELOX AVINZA AVODART AVONEX AXIRON azelastine AZILECT azithromycin AZOPT AZOR
B balsalazide BD INSULIN SYRINGES AND NEEDLES BENICAR BENICAR HCT BENZACLIN benzoyl peroxide BESIVANCE BETIMOL BETOPTIC S BEYAZ BRILINTA brimonidine
bromfenac budesonide inhalation suspension buprenorphine-naloxone sublingual tablet bupropion bupropion ext-rel BYDUREON BYSTOLIC C calcipotriene calcitonin-salmon calcium acetate CANASA
Your specific prescription benefit plan design may not cover certain products or categories, regardless of their appearance in this document. For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative.
candesartan candesartanhydrochlorothiazide CARAC carbamazepine carbamazepine ext-rel carbidopa-levodopa carbidopa-levodopa ext-rel carbidopa-levodopaentacapone carvedilol cefdinir cefprozil cefuroxime axetil CELEBREX cephalexin CETROTIDE cholestyramine ciclopirox CIPRO SUSPENSION ciprofloxacin ciprofloxacin ext-rel ciprofloxacin tablet citalopram CITRANATAL clarithromycin clarithromycin ext-rel clindamycin clindamycin solution clindamycin-benzoyl peroxide clobetasol CLOBEX SPRAY CLODERM clopidogrel clotrimazole clozapine codeine-acetaminophen COLCRYS COMBIGAN COMBIVENT RESPIMAT COPAXONE COREG CR CORTIFOAM COSOPT PF CREON CRESTOR CRINONE cromolyn sodium CYMBALTA D desonide desoximetasone dexamethasone DEXILANT diazepam rectal gel DICLEGIS diclofenac diclofenac sodiummisoprostol dicloxacillin DIFFERIN digoxin diltiazem ext-rel DIOVAN divalproex sodium divalproex sodium ext-rel DIVIGEL
donepezil dorzolamide dorzolamide-timolol doxazosin doxycycline hyclate dronabinol DULERA DUREZOL E econazole EFFIENT ELIDEL ENBREL entacapone EPIDUO EPIPEN EPIPEN JR EPISIL eprosartan erythromycin erythromycin solution erythromycin-benzoyl peroxide erythromycins escitalopram ESTRACE CREAM estradiol estradiol-norethindrone estropipate ethinyl estradioldrospirenone ethinyl estradiollevonorgestrel ethinyl estradiol-norgestimate ethosuximide EVAMIST EVISTA EXALGO EXELON PATCH EXFORGE EXFORGE HCT EXTAVIA F fenofibrate fenofibric acid fentanyl transdermal fentanyl transmucosal lozenge FENTORA FINACEA finasteride FLOVENT DISKUS FLOVENT HFA fluconazole flunisolide fluocinonide fluorouracil fluoxetine fluticasone fluvastatin FOLLISTIM AQ FORADIL FORTEO FORTESTA fosinopril fosinopril-hydrochlorothiazide FOSRENOL
furosemide G gabapentin galantamine galantamine ext-rel GELNIQUE GEL-ONE gentamicin GILENYA glimepiride glipizide glipizide ext-rel glipizide-metformin granisetron H HUMATROPE HUMIRA HUMULIN R U-500 HYALGAN hydrochlorothiazide hydrocodone-acetaminophen hydrocortisone hydrocortisone enema hydromorphone I ibandronate imiquimod INCIVEK INVOKANA ipratropium-albuterol inhalation solution irbesartan irbesartanhydrochlorothiazide itraconazole J JANUMET JANUMET XR JANUVIA JENTADUETO K KADIAN ketoconazole ketorolac L lactulose lamotrigine lamotrigine ext-rel lansoprazole LANTUS latanoprost LATUDA LAZANDA LETAIRIS LEVEMIR levetiracetam levetiracetam ext-rel levofloxacin levothyroxine LIALDA LIPOFEN lisinopril lisinopril-hydrochlorothiazide
LO LOESTRIN FE LOCOID LIPOCREAM LOCOID LOTION losartan losartan-hydrochlorothiazide LOTEMAX LOTRONEX lovastatin LOVAZA LYRICA M meclizine medroxyprogesterone meloxicam MENTAX mesalamine rectal suspension metformin metformin ext-rel methadone methylprednisolone metoclopramide metolazone metoprolol metoprolol succinate ext-rel metronidazole MICARDIS MICARDIS HCT MINASTRIN 24 FE MINIVELLE minocycline mirtazapine mometasone montelukast morphine morphine ext-rel morphine suppository MOVIPREP MOXEZA MUGARD N nadolol NAMENDA naproxen naratriptan NASONEX NATAZIA nateglinide neomycin-polymyxin Bbacitracin-hydrocortisone neomycin-polymyxin Bdexamethasone NEUPRO NEXIUM niacin ext-rel nifedipine ext-rel nitrofurantoin nitroglycerin sublingual spray NITROLINGUAL NITROSTAT NORDITROPIN NOVOLIN 70/30 NOVOLIN N NOVOLIN R NOVOLOG NOVOLOG MIX 70/30 NUCYNTA
NUCYNTA ER NUVARING nystatin O ofloxacin olanzapine omeprazole omeprazole-sodium bicarbonate capsule ondansetron ONETOUCH STRIPS AND KITS ** OPANA ER ORACEA ORTHO EVRA ORTHO TRI-CYCLEN LO ORTHOVISC OSPHENA OVIDREL oxcarbazepine OXSORALEN-ULTRA oxybutynin oxybutynin ext-rel oxycodone oxycodone-acetaminophen OXYCONTIN P pantoprazole paroxetine paroxetine ext-rel PATADAY PATANASE PATANOL peg 3350-electrolytes penicillin VK PENNSAID PENTASA PERFOROMIST phenobarbital phenytoin phenytoin sodium extended PHOSLYRA PICATO pioglitazone pioglitazone-glimepiride pioglitazone-metformin PRADAXA pramipexole pravastatin prednisone PREMARIN PREMARIN CREAM PREMPHASE PREMPRO prenatal vitamins primidone PRISTIQ PROAIR HFA probenecid prochlorperazine progesterone, micronized promethazine propranolol propranolol ext-rel PROTOPIC PROVENTIL HFA PULMICORT FLEXHALER
Your specific prescription benefit plan design may not cover certain products or categories, regardless of their appearance in this document. For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative.
Q QSYMIA quetiapine quinapril quinapril-hydrochlorothiazide QVAR R ramipril ranitidine RAPAFLO RELENZA RELPAX RENVELA repaglinide RESTASIS RETIN-A MICRO ribavirin rimantadine risperidone rivastigmine rizatriptan ropinirole ropinirole ext-rel S
SANCUSO SAVELLA selegiline SEREVENT SEROQUEL XR sertraline sildenafil SIMBRINZA SIMCOR simvastatin SORIATANE SORILUX SPIRIVA spironolactonehydrochlorothiazide sulfacetamide sulfacetamide-sulfur sulfamethoxazoletrimethoprim sulfasalazine sulfasalazine delayed-rel sumatriptan SUMAVEL DOSEPRO SUPRAX SUPREP SYMBICORT SYNTHROID
SABRIL
T TAMIFLU tamsulosin TAZORAC TECFIDERA TEKAMLO TEKTURNA TEKTURNA HCT terazosin terbinafine tablet tetracycline tiagabine timolol maleate solution TOBRADEX OINTMENT TOBRADEX ST tobramycin tobramycin-dexamethasone tolterodine topiramate torsemide TRACLEER TRADJENTA tramadol tramadol ext-rel TRAVATAN Z travoprost trazodone tretinoin
TREXIMET triamcinolone triamterenehydrochlorothiazide TRIBENZOR trimethobenzamide trospium trospium ext-rel
VIOKACE VIVELLE-DOT VOLTAREN GEL VYTORIN
U
X
ULORIC ULTRESA
XARELTO
W warfarin WELCHOL
Z V VAGIFEM valacyclovir valproic acid valsartan-hydrochlorothiazide venlafaxine venlafaxine ext-rel verapamil ext-rel VESICARE VICTOZA VICTRELIS VIGAMOX VIIBRYD VIMOVO VIMPAT
zafirlukast ZENPEP ZETIA ZIOPTAN ziprasidone zolmitriptan zolpidem zolpidem ext-rel ZOMIG NASAL SPRAY zonisamide ZUBSOLV ZUPLENZ ZYCLARA ZYLET
* The Preferred Drug alternative products in this list are a broad representation within therapeutic categories of available treatment options and do not necessarily represent clinical equivalency. ** An Accu-Chek or OneTouch blood glucose meter will be provided at no charge by the manufacturer to those individuals currently using a meter other than Accu-Chek or OneTouch. For more information on how to obtain a blood glucose meter, call toll-free: 1-800-588-4456. Members must have CVS Caremark Mail Service Pharmacy benefits to qualify.
Plan member privacy is important to us. Our employees are trained regarding the appropriate way to handle members' private health information. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers. Listed products are for informational purposes only and are not intended to replace the clinical judgment of the prescriber. The document is subject to state-specific regulations and rules, including, but not limited to, those regarding generic substitution, controlled substance schedules, preference for brands and mandatory generics whenever applicable. The information contained in this document is proprietary. The information may not be copied in whole or in part without written permission. ©2014. All rights reserved.
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Your specific prescription benefit plan design may not cover certain products or categories, regardless of their appearance in this document. For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative.
Your specific prescription benefit plan design may not cover certain products or categories, regardless of their appearance in this document. For specific information, visit www.caremark.com or contact a CVS Caremark Customer Care representative.
