Pharmacy

Each of our medical plan options provides the same prescription drug coverage benefits. Your prescription drug costs will depend on whether you purchase at a retail pharmacy or through mail order, and the type of prescription drugs you buy (such as, generic or brand name). The plan also provides enhanced coverage for specific medications used to treat hypertension, high cholesterol, asthma and diabetes to help members control costs and ensure greater medication compliance.

^{CVS Caremark requires prior authorization, quantity limits and/or specialty guideline management for selected medications and these requirements may change from time to time.}

Barnes Group offers a unique Preventive Generics Medication Program designed to promote medication compliance by offering free generic medications included on the CVS Caremark Preventive Generic Formulary covering more than 14 different diagnostic condition categories and more than 270 generic medications.

For a complete list of current medications available under this program, please review the Preventative Generic Medication List.

When you are enrolled in a Barnes Group medical plan, your coverage will include prescription drug coverage through CVS Caremark. The CVS Caremark website makes it easy to order prescription refills, review the plan’s formulary, get drug cost estimates, identify ways to reduce your medication costs and manage your prescription coverage and benefits.

Register for the Caremark website 

Specialty drugs are prescriptions that are used for the treatment of complex, chronic conditions such as hepatitis, hemophilia, and cancer.

CVS Caremark offers a program for specialty injectable and oral drugs that can provide you with greater convenience, including express delivery, follow-up care calls, expert counseling and superior service and lets you stay in control and on track with flexible, medication pick up or delivery service. Just pick up your medication at any of the 7,600 nationwide CVS pharmacies or have it delivered to your home or work. The choice is yours.

To reach CVS Specialty Pharmacy Services call 1-800-237-2767 or visit www.cvsspecialty.com.

The pharmacy drug list (formulary) is updated regularly. You can access it at CVS Caremark Formulary. If you currently take prescription drugs or need prescription drugs during the year, it is important that you review this formulary list with your doctor. If your prescribed drug is not on the list, discuss with your doctor whether your treatment plan can include a generic alternative or, if not available or tolerated, a high-quality, preferred name-brand drug included in the Advanced Control Drug Formulary.

Please note: CVS Caremark updates its formulary throughout the year (no more than four times annually), so be sure to check your medications regularly against the most current formulary list.

Due to the lack of U.S. Food and Drug Administration (FDA) approval for many ingredients included in compounds and the high cost of these compounded medications, they may not be covered by your prescription plan or may require prior authorization from CVS Caremark. If the compound ingredients are not covered, you will be responsible for the full cost of those ingredients. In situations where the compound ingredients are covered through prior authorization, you will pay the share of the cost specified by your prescription benefits.

Prescription drugs that have an over-the-counter (OTC) equivalent are not covered by the Barnes plans.

Our Step Therapy program helps ensure that you receive appropriate, safe and cost-effective drug therapy. Step Therapy encourages the use of medications you must try first before other treatments are covered, based on clinical practice guidelines and cost-effectiveness.

If your doctor prescribes a brand-name drug for the treatment of an ongoing condition, you will be required to try a medically equivalent but lower-cost alternative to the drug first. You will be contacted before implementation of Step Therapy with a list of the alternative drugs available. After you review the list, you or your pharmacist may contact your doctor to approve the change. If your doctor does not authorize the switch to the preferred drug, the request will be clinically reviewed and you will be informed of the outcome.

Sometimes, your doctor may determine that it is medically necessary for you to take the brand-name version of a drug, even if a generic version is available. If so, your doctor would write "DAW" at the bottom of the prescription. This means that your prescription must be filled with the brand-name version of the medication.

If you use a DAW prescription and receive a drug's brand-name version, you will be required to pay the brand copayment or coinsurance plus the cost difference between the brand and generic drug. If you are unable to take a generic equivalent drug for clinical reasons (for example, you are allergic to the generic filler), your physician can appeal. If your appeal is approved, you can take the brand-name drug without paying the differential.

With the Plan Summary Tool available on the CVS Caremark website you can more easily track expenses against your plan to see how close you are to meeting your deductible and max out-of-pocket.

Copay/Coinsurance Details
Find out what percentage you'll pay for your medications using the CVS Caremark Mail Service Pharmacy and/or participating retail pharmacies table.