The Coverage Review Process is designed to keep up with changes in the prescription marketplace to ensure plan participants are receiving prescription medications that result in appropriate, cost-effective care.

If you are taking any drugs that are subject to coverage review or copay review, or that require a prior authorization, CVS Caremark will need to review additional information from your doctor before they can fill the prescription under your plan.

A Coverage Review  may be necessary when:

• When the medication prescribed is not on the formulary or covered under your plan, or
• When certain prescribed medications are used to treat multiple conditions, or
• When the dosage for medication being prescribed exceeds the FDA (and formulary) limits.

You, your doctor or the pharmacist can initiate a coverage review by calling CVS Caremark, toll-free at 1-833-458-0835.

There are certain medications that may not be covered unless you have first tried another medication or therapy. If the preferred alternative medication does not show in your prescription history with CVS Caremark, then your doctor will need to provide additional information before coverage can be authorized.

For more information on preferred alternative medications, contact CVS Caremark Customer Care.