Prescription drug benefits are provided through:

• the Caremark Retail Program (for short-term prescriptions); and
• the Caremark Mail Service Program (for long-term prescriptions).

Once you satisfy the calendar year family deductible, you pay a co-payment for each prescription (as shown below) and the Plan pays the rest of the cost for the prescription.

Deductible (Calendar Year) . . . . . . .$25 per family

Caremark Retail Program
Co-payment amount for Caremark Participating Pharmacies:

Generic . . . . . . . . . . . . . . . . . . . . . . .10% ($5 minimum)

Brand Name

Produced by more than one manufacturer . 30%
($25 minimum, $50 maximum)
Produced by a single manufacturer . . . . . . .20%
($15 minimum)

Maximum Supply . . . . . . . . . . . . . . . . . . . . . . . . . .34 days

If you do not use a Carmark Participating Pharmacy, you will pay the full price of your prescription, and then send a claim form and the original prescription receipt to Caremark for reimbursement of covered expenses. In most cases, this option will cost more because you will not be receiving the benefit of the discounts offered by Caremark participating pharmacies.

Caremark Mail Service Program
Co-payment amount:
Generic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .($10 minimum)
Brand Name

Produced by more than one manufacturer.30%
($50 minimum, $100 maximum)
Produced by a single manufacturer. . . . . . 20%
($30 minimum)

Maximum Supply . . . . . . . . . . . . . . . . . . . . . . . . .90 days

If you are not sure of the amount of your co-payment, contact "Caremark" at 1.800.776.1465.