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Loyola Prescription (Rx) Plan

COVID-19 Tests

Free, at-home COVID-19 tests are available to Loyola University Chicago faculty and staff through two new federal programs.

Every household in the United States is eligible to order four free, at-⁠home COVID-⁠19 tests through a new government website at: https://www.covidtests.gov/. Orders will usually ship in 7-12 days.

Additionally, on January 10, 2022, the U.S. Department of Labor released guidance to implement President Joe Biden's order that, starting January 15, health plans must cover or reimburse costs for over-the-counter (OTC) at-home rapid COVID-19 tests without requiring health plan participants to pay any of the cost.

This means anyone covered by a Loyola University Chicago medical plan is eligible to receive up to eight FDA-approved, at-home COVID-19 tests each month.

There is no out-of-pocket cost to the member or eligible dependents as long as the tests are purchased at in-network pharmacies. In network pharmacies include Walgreens, CVS, Osco Drug, Walmart, Mariano’s, etc.

To ensure you have no cost or reimbursement forms to submit when buying tests, faculty and staff should present their CVS Caremark prescription card at the time of purchase. If you purchase tests at non-network CVS Caremark pharmacies or retail stores, you must submit a claim form and original receipt for reimbursement, which will be capped at $12 per test.

The CVS Caremark online reimbursement claim form and more information about OTC COVID-19 tests are available on the CVS Caremark website at: https://www.caremark.com/covid19-otc.  

CVS Caremark manages your prescription benefits just like Aetna manages your medical benefits. Outpatient prescriptions (mail order and specialty) must be filled through CVS Caremark. Retail pharmacy prescriptions can be filled at CVS, Walgreens, Target, Walmart, and many more participating pharmacies.  

  • A list of participating pharmacies can be located here:
  • Please note, if you take a specialty medication you must transfer your prescription to CVS Specialty. Simply ask your doctor to send your prescription to CVS Specialty by calling 800.237.2767, e-prescribing, or faxing the request to 800.323.2445. For a list of specialty medications please visit https://www.cvsspecialty.com/wps/portal/specialty/patients/registration.
  • If you enroll in PPO 3 HSA, the medical and prescription drug has a combined deductible. Certain preventive generic drugs may be covered before meeting the deductible. Review the Preventive Therapy Drug List for more information.
  • For CVS Caremark Mail Order Information visit com/mailservice or by phone - call the number on your CVS Caremark member ID card.
  • For additional information, please visit caremark.com.

Same Day On-Demand Rx Delivery

CVS Pharmacy offers prescription delivery within hours in addition to their 1-2 day prescription delivery service available nationwide. The service, delivered by Shipt, a leading same-day delivery marketplace, is available at 6,000 CVS Pharmacy locations across the country, giving you a faster and even more convenient way to get your prescriptions.

Through CVS Pharmacy's delivery offering, the majority of CVS Pharmacy stores across the country are able to offer same-day delivery of eligible prescriptions. When a medication has been filled and is ready for pickup, you can opt to have your medication(s) delivered within hours. You simply select On-Demand prescription delivery service via the CVS Pharmacy app, through SMS text, or by calling your local CVS Pharmacy. The delivery service charge is $7.99 and the packages will be delivered by Shipt.

Along with eligible prescriptions, thousands of the most popular health and household items carried by CVS Pharmacy, including cold and flu remedies, allergy medications, pain relief, first aid, digestive health, vitamins, baby, personal and feminine care products, can be added to delivery orders.

If you don't need your prescription(s) as quickly, or if you are looking for a lower cost delivery option, you can select 1-2 day delivery for a reduced fee of $4.99.

Will I have to enroll separately for prescription coverage?

No. You will automatically be enrolled with CVS Caremark prescription drug coverage if you elect any of the Loyola medical plans.

Will I pay more for prescriptions that are not filled at a CVS Caremark retail network pharmacy?

You will generally pay more for short-term (34 days or fewer) prescriptions that are not filled at a CVS Caremark retail network pharmacy. Short-term prescriptions can be filled at a network pharmacy.

How can I save money on my prescriptions?

  1. Ask for generics first. Generic drugs can cost up to 80 percent less than brand-name drugs.
  2. Remember the preferred drug list. If a generic drug isn't available, ask your doctor to prescribe a drug on your plan's preferred drug list, if appropriate. You will pay more for a brand-name medication not on the preferred list.
  3. Order 90-day supplies of long-term medications to save money. Sign up for CVS Caremark Mail Service to enjoy the convenience of having your medication shipped directly to you at no additional cost.
  4. Fill short-term prescriptions at a network pharmacy. You will generally pay more for short-term (34 days or fewer) prescriptions that are not filled at a CVS Caremark retail network pharmacy.

What CVS Caremark preventive services are covered under the Affordable Care Act?

Affordable Care Act (PDF)

Diabetic Accu-Chek® Meters

Diabetic Accu-Chek® blood glucose meters offered through CVS Caremark are compatible with the formulary test strips, and they are available at no charge through the free diabetic meter program. Please see the Diabetic Meter Program flyer for additional information or learn about tools and resources to help you manage your diabetes.

How are contraceptives covered?

Prescriptions for contraceptives are excluded under Loyola's prescription drug coverage. However, there is a program available whereby you can obtain certain contraceptive prescriptions at no cost to you, as part of the Affordable Care Act. In order to obtain these, you will obtain a separate ID card from CVS Caremark. You must use this separate contraceptive ID card in order to obtain the prescription at no cost.

Note: Medical services for contraceptives are covered separately through Aetna. In order to obtain contraceptive medical services (contraceptive counseling services/office visits, medical procedures for contraceptive services such as contraceptive device implantation and removal, voluntary sterilization (both inpatient and outpatient), and contraceptive devices such as IUDs, implants, diaphragms, and cervical caps), you will need to request and obtain a Contraceptive Services Payment Program ID card from Aetna. Visit the Birth Control Coverage - Religious Employer Exemption section of the Health Insurance page for more information.

Is the coinsurance staying the same?

Yes, the coinsurance and prescription deductibles are staying the same for the 2020 plan year. 

  • Retail Non Preferred Brand and specialty drugs are covered at 55% and you will pay 45% to a maximum of $400 per script.
  • Mail order 3rd tier prescriptions are covered at 75% and you will pay 25% to a maximum of $400 per script. Please reference the formulary list as well as the plan coinsurance structure.

Where can I find the formulary drug list?

The formulary drug list is available online: http://info.caremark.com/druglist - (formulary for January for all medications minus the specialty)

Contraception Prescription

For a list of covered contraceptives, please refer to the Women's Health Preventive Services Contraceptives Drug List.

Why should I consider mail order? And how do I get started?

CVS Caremark Mail Order Information:

  • Two Easy Ways to Get Started
    • Online – visit caremark.com/mailservice, or
    • By Phone - call the number on your CVS Caremark member ID card for live help getting set up.

*Be sure to have a prescription bottle in hand; all the information needed to get started is on the label.

Why Mail Order? By utilizing the 90-day supplies mail order feature, you can find savings on medications you take regularly, such as high blood pressure or diabetes medicine.

*NOTE: CVS Caremark can provide clients with a 30-day retail supply for contraceptives.