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Mail Order Pharmacy: 101

Mail order pharmacies allow for the home delivery of maintenance medications, or prescriptions that are typically taken for chronic conditions (high blood pressure, asthma, diabetes, etc.) Mail order medications are usually supplied in larger quantities such as a 90-day supply and at a lower cost than at a retail pharmacy. Moreover, not only do mail order pharmacies provide convenience to members but also savings.

Pharmacy benefit plan sponsors working with National CooperativeRx would have mail order pharmacy services provided by CVS Caremark Mail Service Pharmacy. The CVS Caremark Mail Service Pharmacy allows for dispensing and shipping of prescription medications from regional pharmacies to patients nationwide. Members can enjoy the convenience of home delivery along with free shipping.

How Does It Work?

CVS Caremark Mail Service Pharmacy fills medication orders the same way retail pharmacies do. A pharmacist completes the required steps to verify and fill the medication order, but instead of physically handing the medication to a patient, the medication is mailed to the patient’s home, or preferred location if on vacation or at work. When mailed, medications are sent in secure, tamper-resistant, and/or temperature-controlled packaging. Digitally enrolled patients will be able to monitor the status of their order and will be provided with shipping and tracking information. Similar to retail pharmacy medications, automatic refills are available. Additionally, at any step during the process, patients can speak to a pharmacist about the medication. To see CVS Caremark’s Mail Service Pharmacy in action, view this video.

How Do Members Sign Up?

Members can sign up to get their prescriptions delivered by mail from CVS Caremark Mail Service Pharmacy in many ways. Below are the four enrollment options:

1. Members can create an account at caremark.com or log in to their existing accounts. Then, they can select “Start Rx Delivery by Mail” from the Prescriptions tab, and they’ll be taken directly to the Check Drug Cost tool. There, they can search for their medication name and dose. The search tool will provide a list of results that could include delivery, pick-up, and dosage options, as well as generic and therapeutic alternatives. They can then select an option with “90-day supply mail service” and click “Request a New Prescription.” Members can review their order and click or tap “Submit Refills” to request a new 90-day supply of their prescription. CVS Caremark will contact their doctor for approval and then process the order. Members should have their prescription and prescriber information available when they complete these steps. This enrollment option is considered the easiest.

Members can watch a step-by-step video here.

2. Members can call customer care toll-free at 1-866-818-6911 and let customer care know they would like to get set up with CVS Caremark Mail Service Pharmacy. CVS Caremark will contact their doctor for prescription approval and then process their order. Members should have their prescription and prescriber information available when they call.

3. Prescribers can call toll-free at 1-800-378-5697 or send new electronic prescriptions to CVS Caremark Mail Service Pharmacy (NCPDP ID: 0322038). Members will still need to contact CVS Caremark Mail Service Pharmacy by phone to create an account and confirm billing and shipping information.

4. Members can visit caremark.com and click on the help center link at the top right corner of the page. From there, they can hover over “Prescriptions” in the toolbar and select print plan forms. Here, members can access the mail order enrollment form. Members can complete, print, and mail it in with a hard copy prescription for processing. This enrollment option will take the longest and members should allow at least 14 days for processing.

As a Plan Sponsor, How Can I Encourage Utilization of CVS Caremark’s Mail Service Pharmacy?

One of the best ways to encourage mail order utilization is through plan design. CVS Caremark offers a unique program called Maintenance Choice that plan sponsors can add to their plans. The Maintenance Choice Network allows members to have a retail pharmacy experience, but access mail order pricing. The Maintenance Choice Network can be set up by plan sponsors in a voluntary fashion, which allows members the option to fill a 90-day prescription at a CVS Retail Pharmacy, but it is not mandated. Alternatively, this program can be added in an incentivized fashion, where members pay more if they continue using non-CVS retail pharmacies, or a mandatory fashion, where members are required to use CVS Retail or Mail Service Pharmacies after a certain number of grace fills. Of course, a mandatory network will drive the largest savings for plan sponsors but comes with the most potential for disruption.

Additionally, plan sponsors can encourage mail order utilization by creating cost-share incentives. The options are endless, but generally the bigger the incentive, the larger the participation. A couple of options to consider:

  • Two copays/90-day mail prescription, compared to one copay/30-day prescription
  • Removal of copay on generics at mail service
  • Reduced co-insurance percentages

Is There Anything Else Members Should Know About CVS Caremark Mail Service Pharmacy?

While mail order prescriptions are great in many instances, there are a few times when it might not be the ideal dispensing location. Unfortunately, compounded medications cannot be dispensed from CVS Caremark Mail Service Pharmacy due to restrictions from the U.S. Postal Service. Additionally, Class II (CII) controlled substance medications, if dispensed by mail service, might be subject to different limitations and restrictions based on patient/prescriber/pharmacy state laws. Generally speaking, mail service can dispense CII prescriptions, but it might be easier for members to obtain these at a local retail pharmacy. Finally, it’s important to note that CVS Caremark Mail Service Pharmacy does not accept manufacturer copay assistance cards that reduce member cost sharing, so please keep this in mind when selecting your mail order cost shares.

CVS Caremark Mail Service Pharmacy

The CVS Caremark Mail Service Pharmacy is safe, convenient, and cost-effective. If you are interested in learning more about the Maintenance Choice Network or encouraging mail order utilization through plan design, please reach out to your strategic account executive at National CooperativeRx.

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