Pharmacy Resources

Welcome to CommunityCare Pharmacy Resources

Pharmacy Benefit Manager (PBM) Change in 2019
CommunityCare will be using CVS for PBM services starting in 2019. Click here to find out what that means for you.

Use the information below to learn more about your prescription coverage.

Getting the most of your prescription benefits

Starting January 1, 2019 CVS will be working with CommunityCare to administer the prescription benefit portion of your health plan.

Caremark.com is an easy way to make the most of your prescription benefits:

  • Find network pharmacies
  • Refill medication and check order status
  • Check drug costs
  • See your prescription history
  • View formulary alternatives

Register at Caremark.com/startnow to get started.

Mail Order Prescription Drug Program

CommunityCare is pleased to provide quality pharmacy services to its members, including a mail order pharmacy program.

Members have two options for ordering mail order prescriptions. Please click on the links below for more information.

Large Group $0 Copay Program

Helping members save money on prescription drugs while improving health outcomes. Our zero copay program was developed to lower out-of-pocket costs for certain prescription drugs and promote compliance with prescribed drug therapy. Essentially, this program reduces the copayment for select formulary generic drugs to $0!

Prescriptions filled at a participating pharmacy (retail or mail order) for any of the generic drugs listed on the information sheet will be filled for a $0 copay!

2019 Plans

2018 Plans

Small Group ACA Preventive

Below are CommunityCare's coverage of preventive services without cost-sharing requirements.

Specialty Pharmacy Program

Save money on specialty medications with the Specialty Pharmacy Program. Specialty medications typically cost more than common prescriptions plus usually require additional clinical support for optimal health outcomes. This specialty pharmacy program helps make these medications accessible and cost effective for our members.

CommunityCare is pleased to provide quality pharmacy services to its members, including a specialty pharmacy program. Members have two options for ordering specialty prescriptions. Please click on the links below for more information.

Prescription Drug Coverage Determination

A prescription drug coverage determination is used to request a drug formulary exception for medications that are not on CommunityCare's formulary list or drugs that are on CommunityCare's formulary list but require a utilization management decision (prior authorization, quantity limit or step therapy).