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: 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.
Medications for Weight Management FAQ
Additional Discount Resources
Wegovy Savings Card
Zepbound Savings Card
BENEFIT RESOURCES & INFORMATION
Announcement: 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.
Medications for Weight Management FAQ
Additional Discount Resources
Wegovy Savings Card
Zepbound Savings Card
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.
The coverage of weight loss medications comes with Utilization Management. Utilization Management (UM) programs review prescription drugs for medical necessity, appropriate use and safety, and include prior authorization, quantity limits and/or required use of lower-cost options before coverage of certain drugs. Prior authorization requirements align with the FDA label for each medication and current clinical guidelines.
Members are required to work with both CVS Caremark and their medical providers to obtain coverage under the plan. Members can obtain the Coverage Review process online or contact CVS Caremark at (833) 458-0835. Weight loss medications available under the plan are determined by the CVS Caremark Formulary.
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