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[PDF File]Understanding Your Prescription Benefit Plan: Guide to the ...
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Blue Cross Blue Shield of Illinois: CVS Caremark Health Savings Plan 3 Coverage Period: 06/01/2014 - 05/31/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family| Plan Type: HDHP
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[PDF File]QUANTITY LIMIT CRITERIA - Caremark
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manufacturers affiliated with CVS Caremark. 106-40034A 092817 Understanding Your Prescription Benefit Plan: Guide to the CVS Caremark® Formulary (for Aetna/Innovation Health and CareFirst Participants) Your coverage under CVS Caremark is based …
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[PDF File]Summary of Benefits and Coverage: What this Plan Covers ...
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Below is a list of medications that will not be covered without a prior authorization for medical necessity. If you continue using one of these drugs without prior approval, you may be required
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[PDF File]Blue Cross Blue Shield of Illinois: CVS Caremark Health ...
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Get the most from your Prescription Discount Drug Program. The Blue Cross and Blue Shield Service Benefit Plan is pleased to offer a Discount Drug Program to our Plan members for specific drugs not covered under the prescription drug benefit. It is a way for you to get lower prices on prescription drugs at most retail pharmacies.
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Erectile Dysfunction medications limited to 6 pills/month. Maintenance medications must be filled as a 90-day supply at a CVS/pharmacy or through CVS Caremark Mail Order Pharmacy after two initial 30 day supplies are filled. There are some formulary exclusions and a non-formulary exceptions process for brand drugs that are not covered.
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