Prescriptions and the HDHP
Are my prescription costs covered if I'm enrolled in the High-Deductible Health Plan (HDHP)?
In the HDHP, preventive medicines and nonpreventive medicines are covered differently. Nonpreventive drugs are included in the HDHP deductible along with nonpreventive medical expenses. After you meet the annual HDHP deductible, your nonpreventive prescription costs are covered by the plan and you are responsible for coinsurance. Preventive care medicines are always covered as if the deductible did not exist and you will be responsible for either a copay or coinsurance.
What are preventive care medicines?
As defined by the government, preventive care medicines are:
- Those taken by a person who has developed risk factors for a disease that has not yet become a health issue.
- Those taken to prevent the reoccurrence of a disease from which a person has recovered.
- Those used as part of preventive care procedures such as obesity and tobacco cessation.
How can I tell if my medicines are preventive and, therefore, excluded from the deductible?
Simply review the Preventive Drug List to see if your medicines are considered preventive.
How will the pharmacist know how much to charge me?
Whether you fill your preventive care prescription through the CVS Caremark Mail Service Program or at a participating retail pharmacy in the CVS Caremark network, your HDHP benefits are set up to recognize your prescription as a preventive care medicine and automatically process it appropriately.