Prescription Information

Besides offering convenience, we're constantly looking for ways to improve health plan benefits and programs, while remaining cost-effective.

Please note: Prescription drug benefits vary among EHP employer groups. The information included on this page is for informational purposes only. Certain programs referenced in this information, and in some cases the pharmacy benefit itself, are not applicable to all EHP employer groups. Be sure to consult your Summary Plan Description (SPD) for information on specific plan coverage, limitations, and exclusions. Your HR office will be able to provide you with your SPD.

Pharmacy Formulary & Co-pay
Generic Substitution
Retail Pharmacy Network

Pharmacy Formulary & Co-pay

 All EHP members covered by the EHP pharmacy benefit have a three-tier drug benefit based on the EHP Pharmacy Formulary and are responsible for a portion of the cost of their medications.  With a three-tier drug benefit, your prescription medications fall into one of three tiers. Each tier has a different co-pay.

The EHP pharmacy formulary consists of the following tiers:

• Tier One:  Generic Medications are the most affordable and have the lowest co-pay. Generic drugs contain the same active ingredients as brand-name medications and are approved by the Food and Drug Administration.  Generics are chemically and therapeutically equivalent to brand drugs, but are available at a lower price.
• Tier Two: Preferred Brand Medications (middle co-pay) are  brand-name drugs have been identified as safe and effective for treatment of most medical conditions.
• Tier Three:  Non-Preferred Brand Medications (highest co-pay) often have either a generic equivalent or a preferred-brand alternative. This tier also includes new products not yet reviewed by the Johns Hopkins Health Care Pharmacy and Therapeutics Committee.

You can use information in the formulary to help you identify the tier status of medication you are taking and discuss less expensive alternatives with your doctor.  To determine your co-pay or find a lower-cost generic or preferred brand alternative for a medication, visit www.caremark.com and select Check Drug Cost (registration is required for first time use)

For more information, see our  Pharmacy Formulary.

The EHP Pharmacy Formulary is subject to change at any time. The Formulary is updated on a regular basis, including when a new generic or brand-name medications becomes available and as discontinued drugs are removed from the marketplace.

 Generic Substitution

EHP encourages use of generic medications. Generic drugs are chemically identical to their branded counterparts. They are made with the same active ingredients, and produce the same effects as their brand name equivalents. The Food and Drug Administration (FDA) requires generic drugs to have the same quality, strength, purity, and stability as brand name drugs. Also, the FDA requires that all drugs, including generic drugs be safe and effective.

Although generic drugs are chemically identical to their branded counterparts, and are held to the same FDA standards for safety and performance as brand name drugs, they sell for 30-75 percent less. You can save money by choosing generic drugs when they are available. Additional information on generic drugs is available on the FDA web site at, www.fda.gov/cder/ogd/

Brand-name drugs with generic equivalents available are placed in Tier 3 of the EHP Pharmacy Formulary. If you choose a brand name drug with a generic equivalent, you will be required to pay a higher cost share.

Your  cost share for brand name drugs with a generic equivalent available is determined by your  employer’s Summary Plan Description (SPD). Depending on your employer-specific benefit, you may be required to pay the highest co-pay (Tier 3) or pay the highest co-pay plus the difference in price between the brand and its generic equivalent.

Retail Pharmacy Network:

The retail pharmacy network includes over 64,000 pharmacies nationwide. The network includes most chain retailers and independent pharmacies. To search for a participating network pharmacy near you, click here www.caremark.com. (Registration is required for first time use.)

Mail Order:
This service offers a convenient and cost-effective option for obtaining  medications you take on an ongoing basis. You can receive up to a 90 day supply of chronic use medications and have these medications delivered to the location of your choice. Mail Order service is provided by CVS Caremark.  For additional information and to order a refill on your mail order prescription, click here, www.caremark.com  and select Refill a Prescription. (registration is required for first time use) For a Mail Order Form Click here.

Drug Information:
To view information on a drug, including how to take the medication, the possible side effects and drug interactions, click here: www.caremark.com and select Drug Search. Please also see our Pharmacy FAQs for more information.

Please note general information about prescriptions and pharmacy benefits can be found in our FAQ.