Just like the awkward rollout of NYSHIP’s new Mental Health/Substance Abuse care provider, the switch to CVS Caremark for managing prescription drugs under NYSHIP–a change that went into effect on Jan. 1, 2014–has been confusing and frustrating.  Some students reported their pharmacies not accepting their insurance and the CVS Caremark information sent out to NYSHIP enrollees looked like junk mail and was far from informative.  So in the absence of this information being directly and readily available from NYSHIP and CVS Caremark, here are the answers to a couple of the questions arising that I’ve been able to investigate.

Do I have to get my prescriptions filled at CVS?  

Absolutely not.  CVS Caremark administers the mail-order prescriptions, but it seems like there is no change in what local pharmacies will accept your insurance.  Pharmacy chains like Rite Aid, Duane Reade/Walgreens, PathMark, Costco, CVS (of course), and many independent pharmacies all will still accept our NYSHIP insurance.  If you are looking for a list of pharmacies near you that accept our insurance, check the pharmacy locator here or under “Understand My Plan & Benefits” when you sign into your CVS Caremark account (more on how to do that in a minute).

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So why did my pharmacy say they couldn’t apply my insurance to my prescription?

Right before the semester break, CVS Caremark sent a letter with a one-time use card (just a piece of paper) that is needed by a pharmacist to update your insurance information in their system and allow them to process your script and charge you the co-pay only.  You need to show this card just the first time you get a prescription filled at every different pharmacy or pharmacy chain you use.

Uh oh.  I think I might have thrown that out.  Now what?

You’ll be forgiven if you thought that piece of mail looked like junk mail and threw it out without opening it.  You can actually print yourself a new one from here and fill it out with your NYSHIP ID number (found below your name on your NYSHIP insurance card. It is nine digits long and will start with 890) and name.

While I was so confused about all of this, I paid full price for a prescription.  Is there a way to get my money back?

Definitely.  When you sign in to your CVS Caremark account, hover over the “Understanding My Plan & Benefits” tab and click on “Make a Reimbursement Claim” on the right in the box that appears.

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You will get sent to a page with a Claims Reimbursement form and a FAQ page to help you fill it out, if needed.

So I need an account for CVS Caremark?

It’s not entirely necessary, but is probably the easiest way to find information about your prescriptions, especially mail-order, as well as drug prices, pharmacy locations, etc. If you had an account before with MedCo/Express Scripts, you’ll still have to make a new account, as none of your account information was transferred over.  If you decide to make an account, register here.  Have your NYSHIP member ID number ready (remember, that’s that one found below your name on your NYSHIP card and it starts with 890).  The process is fairly quick and easy.

How do I get set up with mail-order prescriptions?

If you had any refills of prescriptions left from Express Scripts, they have been automatically transferred to CVS Caremark.  However, you need to contact CVS Caremark to set up billing information (Call the NYSHIP line and go through all the automated steps to reach a representative.  1-877-7-NYSHIP).  For new mail-order requests, you will need to submit the Mail Service Order Form that was included in the CVS Caremark mailing back in late December.  It can also be found here.  Once you are set up, you can manage your prescriptions from your CVS Caremark account.  Your doctor can also fax new scripts needing 90-day supplies directly to CVS Caremark (1-800-378-0323) or call them in (1-800-378-5697).  Orders take two days to process and generally four or five to arrive in the mail, so allow yourself at least a week before the prescription is needed.

If you are still having issues with filling your prescriptions, contact CVS Caremark via NYSHIP at 1-877-7-NYSHIP (1-877-769-7447).  Also, keep me informed if it’s something that could affect other GC students so that we can troubleshoot and advise on the issue.  Send me, Jen, an email at health@cunydsc.org.