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TX Employees: Important Update Regarding Potential Changes to Your Healthcare Network Here.

TX Employees: Important Update Regarding Potential Changes to Your Healthcare Network Here.

Pharmacy

Overview

When you enroll in one of the Publicis medical plans, you automatically receive prescription drug benefits through CVS Caremark. You’ll find a recap of prescription benefit information on this page. You can find more information here or by calling CVS Caremark Customer Service at 1-866-212-4752.

Drug tiers

The cost of your prescription drugs depends on the tier of the medication:

  • Generic — Generic drugs contain the same active ingredients as their brand-name equivalents and meet the same federal standards for safety, but typically cost significantly less.

  • Brand formulary — Brand formulary prescription drugs are favored by a prescription plan based on drug effectiveness and cost.

  • Brand non-formulary — Brand non-formulary prescription drugs are not on a prescription plan’s favored list (or formulary) based on drug effectiveness and cost. Non-preferred drugs still may be covered, but may require prior authorization and cost more.

Get your medications delivered by mail

Switch over to 90-day supplies from CVS Caremark Mail Service Pharmacy, and you’ll get your medications delivered right to your home—with no-cost shipping.

Save money with generic medications

Generic medications are generally just as effective as brand-name medications, and you could save up to 80% using the generic option. Ask your doctor about generic medications. See if generic options are right for you with this interactive widget. To learn more, access the Documents section on this page.

Coverage

Retail prescriptions (your cost for a 30-day supply)

 Medical HSA PlanStandard PPO Plan and Premier PPO Plan
  GenericYou pay 100% of prescription drug expenses until plan deductible is met; you pay 20% coinsuranceYou pay 20% after deductible
Minimum: $10
Maximum: $50
  Brand FormularyYou pay 100% of prescription drug expenses until plan deductible is met; you pay 20% coinsuranceYou pay 20% after deductible
Minimum: $35
Maximum: $100
  Brand Non-formularyYou pay 100% of prescription drug expenses until plan deductible is met; you pay 20% coinsuranceYou pay 20% after deductible
Minimum: $55
Maximum: $200

Mail order prescriptions (your cost for a 90-day supply)

 Medical HSA PlanStandard PPO Plan and Premier PPO Plan
  GenericYou pay 100% of prescription drug expenses until plan deductible is met; you pay 20% coinsuranceYou pay 20%
Minimum: $25
Maximum: $125
  Brand FormularyYou pay 100% of prescription drug expenses until plan deductible is met; you pay 20% coinsuranceYou pay 20%
Minimum: $75
Maximum: $250
  Brand Non-formularyYou pay 100% of prescription drug expenses until plan deductible is met; you pay 20% coinsuranceYou pay 20%
Minimum: $137.50
Maximum: $500

Note: CVS Caremark requires prior authorization, quantity limits and/or specialty guideline management for selected medications, and these requirements may change from time to time. For more information about these medications, contact CVS Caremark.

Plan Features

CVS Caremark

With CVS Caremark, you’ll have access to more than 7,800 CVS Pharmacy stores nationwide. You’ll also be able to obtain prescriptions from licensed non-CVS pharmacies such as Walgreens, Rite Aid and more.

Register online, and you’ll gain access to CVS resources to help you choose and manage prescriptions, such as Check Drug Costs & Coverage and Pharmacy Locator. You’ll also be able to print out a member ID card.

Mandatory Maintenance Choice Program (applies only to long-term maintenance medications)

A maintenance medication is one that’s taken regularly to treat or manage a chronic condition or for long-term therapy. The Maintenance Choice Program provides you with the ability to fill 90-day supply prescriptions of your long-term maintenance medications at lower copays. With lower copays for 90-day-supply fills, you can realize significant savings over time for medications you take on a regular basis to treat or manage a chronic condition.

With Maintenance Choice, you can choose to fill your 90-day supplies at either CVS retail pharmacy locations (including those inside Target locations), or receive them through CVS Mail Service Pharmacy. Note: 90-day supplies of maintenance medications cannot be filled at non-CVS network pharmacies.

Fill Limit for 30- or 34-Day Supply of Maintenance Medications

The plan allows two (2) grace fills of maintenance medications at a 30- or 34-day supply to be filled at any network pharmacy (includes CVS retail pharmacies and non-CVS network pharmacies such as Walgreens, Rite-Aid and Duane Reade). The two grace fills do not have to be consecutive, and if you are taking more than one medication, the two grace fills apply to each maintenance medication you are taking. After the second 30- or 34-day fill, your maintenance medication(s) will be managed according to Maintenance Choice provisions and will be required to be filled as a 90-day supply at either a CVS Pharmacy or through CVS Mail Service Pharmacy.

You will need to have your doctor submit a new 90-day-supply prescription for your maintenance medication(s) to CVS Pharmacy or the CVS Mail Service Pharmacy accordingly. Keep in mind, if you attempt to fill your maintenance medication(s) after exhausting your two-grace-fill limit without a new 90-day-supply prescription, the plan will deny the charges and you will be responsible for the full cost of the medication.

How to get started

To fill prescriptions for long-term medications at a CVS Pharmacy:

  • Ask your doctor for a 90-day prescription for your long-term medication(s) and have your doctor send it to the CVS Pharmacy of your choice. To find a pharmacy location near you, sign in at CVS Caremark and click “Find a Pharmacy” (in the “Order Prescriptions” section).

  • Call or visit your local CVS Pharmacy to speak with a pharmacist filling prescriptions for maintenance medications through CVS Mail Service Pharmacy.

  • Visit the CVS Mail Service Pharmacy website and sign in or register to request a new prescription.

  • Call the toll-free number on the back of your CVS Caremark prescription benefit ID card.

Dispense as written charges

If you want to fill a prescription for a brand medication when a generic equivalent is available, you will pay the applicable copay, plus the difference in cost between the brand medication and the generic equivalent.

Providing employees with $0 copay to specialty medications

At Publicis Groupe, we are aware of the cost of specialty medications for our employees. That’s why we are collaborating with CVS Caremark and PrudentRx to make sure you pay $0 out-of-pocket for any medications on your Specialty Drug List when you fill at CVS Specialty. Learn more here.

What are specialty medications?

Specialty medications are used for the treatment of complex, chronic conditions, such as hepatitis, hemophilia and cancer. CVS Caremark offers a program for specialty injectable and oral drugs that can provide you with greater convenience, including express delivery, follow-up care calls, expert counseling and superior service. Specialty drug prescriptions can also be filled at CVS retail pharmacies. CVS Pharmacies with a MinuteClinic will also have services that provide education regarding your medications or injectables.

CVS MinuteClinic

CVS MinuteClinic offers quick and easy access to the care you need if you’re enrolled in a Publicis medical plan option. You’ll receive a discount off standard MinuteClinic fees when you present your CVS ID card at one of more than nearly 1,000 MinuteClinic Centers nationwide. These walk-in medical clinics have on-staff nurse practitioners and physician assistants who specialize in family care (for family members 18 months and older).

Step Therapy Program

The prescription drug Step Therapy program helps ensure that you receive appropriate, safe and cost-effective drug therapy. Step Therapy encourages the use of therapies that should be tried first, before other treatments are covered, based on clinical practice guidelines and cost-effectiveness.

If your doctor prescribes a brand-name drug for the treatment of an ongoing condition, you will be required to try a medically equivalent but lower-cost alternative to the drug first. You’ll be contacted before implementation of Step Therapy with a list of the alternative drugs available. After you review the list, you or your pharmacist may contact your doctor to approve the change. If your doctor does not authorize the switch to the preferred drug, the request will be clinically reviewed and you will be informed of the outcome.

Coverage of Compound Medications

Due to the lack of U.S. Food and Drug Administration (FDA) approval for many ingredients included in compounds and the high cost of these compounded medications, they may not be covered by your prescription drug benefits or may require a prior authorization. If the compound ingredients are not covered, you will be responsible for the full cost of those ingredients. In situations where the compound ingredients are covered through prior authorization, you will pay the cost share specified by your prescription benefits.

CVS Caremark Diabetes Management Program (featuring Transform Diabetes Care®)

We’re making your and your family members’ Transform Diabetes Care® experience even better, helping you to meet your personal goals so you can live your best life. Transform Diabetes Care® expands beyond blood glucose testing so that, based on your needs, you may receive help managing and staying on track with your medications, reminders about important health screenings and tests, and guidance on healthy nutrition and lifestyle habits. The Transform Diabetes Care® program provides the following at no cost:

  • A digital meter, which automatically sends your blood glucose readings straight to your online account—no log books or sync cables needed. It also provides real-time health tips based on your current reading.

  • Phone support from certified diabetes educators if your level is out of range or you need assistance.

  • Unlimited test strips and lancets delivered right to your door.

  • Receive timely notices about medication refills.

  • Message with a health coach and personalized support from a Certified Diabetes Care Nurse.

  • Two available vouchers for comprehensive diabetes visits at MinuteClinic locations at no out-of-pocket cost, include A1C checks. MinuteClinic can be reached at 1-866-389-2727.

Get started today. Call the number on the back of your prescription ID card.

Preventive Drug List for the Medical HSA Plan

Employees enrolled in the Medical HSA Plan will see lower costs when they fill prescriptions for preventive drugs that are included in a new list managed by CVS Caremark. The new list includes select prescriptions that help prevent chronic health conditions when taken regularly. Employees who use medications on the Preventive Drug List will be responsible for only the copay or coinsurance for these medications, even if they have not satisfied their annual deductible.

Note: You may be required to use mail-order services for any maintenance medications you take to prevent chronic conditions.

Standard and Advanced Control Formularies

The Standard and Advanced Control Specialty Formularies are in place to ensure access to clinically appropriate and cost-effective drug therapies. CVS Caremark continually reviews drugs on the formularies and will either add products that have demonstrated enhanced clinical efficacy (and/or provide more convenient dosage forms) or remove products that have less convenient dosages, may have more side effects or may cost more when compared with available options on the CVS Caremark Drug List. If a medication you are taking is affected by a change to the formulary, you will be contacted by CVS Caremark.

Find drugs on the formulary and see your prescription costs by logging in to your member account at CVS Caremark.

CVS Caremark Prescription Drug Benefit Resources and Provisions

CVS Caremark provides members with access to a national network of 68,000 participating pharmacies. You enjoy better savings when you fill your prescription medications at any one of the CVS Pharmacy stores nationwide (including CVS Pharmacy at Target locations). However, you also have the option of obtaining your prescription medications from any participating licensed non-CVS Pharmacy (i.e., Walgreens, Rite Aid).

CVS Caremark’s user-friendly website and intuitive mobile apps allow you to manage your prescriptions, find health information and more from your smartphone or tablet. Online features include:

  • Fast and convenient mail service for new prescriptions and online refills

  • Expedited new prescription mail service orders with Fast Start

  • Your prescription history

  • Tools that allow you to check for lowest-price options

  • Ask-a-Pharmacist and Customer Care to answer your questions

  • Information about drug interactions with other drugs, vitamins and foods

  • Health information about specific conditions through Self-Care Centers

Visit CVS Caremark for more information.

CVS ExtraCare Health Card

The ExtraCare Health Card gives you 20% savings on thousands of regularly priced CVS Pharmacy Brand health-related items valued at $1 or more. Two ExtraCare Health Card key tags for your family to use will be mailed to your home address.

The card is provided to you at no cost! You can use the card at any CVS Pharmacy register to receive your discount. You can also save money on all eligible items purchased on the CVS Pharmacy website.