All health plan options have prescription drug coverage. CVS/Caremark manages the prescription benefits for KEHP, but you do not have to use a CVS pharmacy. Go to any in-network pharmacy and get a 30 or 90-day supply. If you prefer to have your prescriptions delivered to your door, use the CVS/Caremark retail mail order program. Sign up at caremark.com.
Drug coverage is limited to drugs on the Value Formulary. You can view both the condensed and detailed versions of the Value Formulary at kehp.ky.gov or at caremark.com. Some drugs are subject to prior authorization. An appeals process is available for drugs prescribed by a physician where usage or dosage is contrary to FDA approval. For specific questions about your prescriptions, contact CVS/Caremark at 866-601-6934. You may want to share the formulary listing with your primary care physician or other providers.
Value Benefits for Diabetes, COPD and Asthma
As costs of prescription drugs continue to rise, KEHP wants to help you by reducing what you have to pay! For several years, KEHP has offered Value Benefits, and we now know that you are being more compliant in taking your medications — because they cost you less! This is effective in improving your health, saving you money, and reducing plan costs. It’s a win-win for all!
The Value Benefit for diabetes, COPD, and asthma means your costs are reduced if you receive maintenance prescriptions or supplies. Some examples include:
Blood pressure monitoring devices
Supplies and durable medical equipment
You will pay a reduced co-pay and/or co-insurance, and you won’t have a deductible.
Most supplies and durable medical equipment related to diabetes, COPD, and asthma are covered in full with NO DEDUCTIBLE.