Non-Medicare Prescription Plan - CVS Caremark
Individuals enrolled in a State of Delaware non-Medicare health plan, administered by Highmark Delaware or Aetna, are automatically enrolled in the State of Delaware prescription plan. CVS Caremark is the pharmacy benefit manager for the State of Delaware.
CVS Caremark provides an Automatic Refill and Renewal program for home delivery, CVS Pharmacy Pickup and Delivery Options, CVS Specialty Pharmacy and over 66,000 pharmacies are available under the CVS Caremark network.
IMPORTANT: The Spousal Coordination of Benefits (SCOB) Policy applies to prescription drug coverage, and is used to determine your spouse’s benefit eligibility status under the State of Delaware Group Health Insurance Plan (GHIP).
Announcement: At the March 9, 2026 State Employee Benefits Committee (SEBC) meeting, the Committee voted to increase the copay to $200 per 30-day supply for GLP-1 medications for weight management, such as Wegovy and Zepbound*, effective July 1, 2026 for non-Medicare prescription plan participants. This copay will be excluded from prescription out-of-pocket maximums.
* Zepbound is currently excluded from the State of Delaware’s formulary, however, coverage may be approved through the clinical exception process for eligible members. The $200 copay will apply to any current and future medications in this drug class.
Learn more by selecting Medications for Weight Management under BENEFIT RESOURCES & INFORMATION below.
BENEFIT RESOURCES & INFORMATION
Effective July 1, 2026, the GLP-1 medications for weight management, such as Wegovy and Zepbound*, will be subject to a $200 copay for non-Medicare prescription plan participants. This copay will be excluded from prescription out-of-pocket maximums.
* Zepbound is currently excluded from the State of Delaware’s formulary, however, coverage may be approved through the clinical exception process for eligible members. The $200 copay will apply to any current and future medications in this drug class.
Additional Discount Resources
Members using Wegovy have the option to reduce their out-of-pocket cost by using the Wegovy Savings Card offered by Novo Nordisk, which provides savings of up to $100 per month at the pharmacy. Members can apply online through NovoCare Wegovy.
For members who received a clinical exception for Zepbound, a similar Zepbound Savings Card is available online through Lilly which provides savings of up to $100 per month at the pharmacy.
Disclaimer: The Statewide Benefits Office maintains no affiliation with third party retailers and/or discount programs and is not liable for any issues resulting from clicking on these links or the purchasing of products.
CVS has partnered with PrudentRx to offer additional cost savings. PrudentRx allow members to get specialty medications at no cost to them by obtaining copay assistance from drug manufacturers. Learn More
The Maintenance Medication Program provides additional cost savings by allowing members to fill a 90-day prescription at a reduced copay. Learn More
Disclaimer: The Statewide Benefits Office maintains no affiliation with third party retailers and/or discount programs and is not liable for any issues resulting from clicking on these links or the purchasing of products.
A generic drug is a medication created to be the same as an already marketed brand-name drug. Learn More