CVS Caremark Specialty Pharmacy: specialty pharmacy & medications
CVS Caremark Specialty Pharmacy will give you easy access to specialty medications priced at your Benefit Amount.
How CVS Caremark Specialty Pharmacy works with your Sidecar Health benefits:
Always ask for generic. Only generic alternatives will be priced at your Benefit Amount. You will be balance billed if you order brand name specialty drugs with generic alternatives, as those are not priced at your Benefit Amount. If you believe you require a brand name specialty drug, reach out to Sidecar Health Member Care at (855) 282-0822.
To access pricing at your Benefit Amount, you must enroll with CVS Caremark Specialty Pharmacy.
You can pick one of the following ways to get started:
- Call CVS Caremark Specialty Pharmacy (800) 237-2767.
- Enroll online.
- Ask your provider to fax (800) 323-2445 or e-prescribe your prescription to “CVS Caremark Specialty Pharmacy.”
CVS Caremark Specialty Pharmacy allows you the following benefits:
- No payment required: Sidecar Health will pay CVS directly, except in the following cases, you will have to pay your portion of the expense to CVS:
- You have an applicable outstanding deductible
- You order brand name specialty drugs when there is a generic alternative
- No pre-bill required: Even for drugs that are more than $750, no need to submit a pre-bill to us.
- No expense upload: CVS will send claims directly to Sidecar Health and we will upload a new expense on your behalf.
- Delivery: Unless requested otherwise, your medications will be delivered to you.
For more information on how to get started, visit https://www.cvsspecialty.com/getting-started/welcome.html.
FAQS
AM I REQUIRED TO USE CVS CAREMARK SPECIALTY PHARMACY?
No. Your Benefit Amounts for prescription drugs will always be the same no matter what pharmacy you choose for your specialty medications.
WHICH DRUGS CAN I GET THROUGH THE CVS CAREMARK SPECIALTY PROCESS?
The CVS Caremark Specialty process only covers specialty medications that cannot be procured from a retail pharmacy. If you have questions on which medications are covered, call Sidecar Health Member Care at (855) 282-0822.
WHAT DO I DO IF I WAS ALREADY USING CVS SPECIALTY PHARMACY?
You need to inform CVS Caremark Specialty Pharmacy before your next refill that your insurance has changed. To do so, call the CVS Caremark Specialty customer service line at (800) 237-2767.
CAN I USE MANUFACTURER ASSISTANCE?
Yes. If your prescription cost is subject to the deductible, CVS can apply any available manufacturer assistance to reduce your out-of-pocket costs for the drug.
Sidecar Health does not utilize a network of providers. External websites and information on healthcare providers, including cost and quality information, is provided for convenience and informational purposes and is not an endorsement or guarantee of pricing, quality, or availability of the provider. Contact the provider for pricing and availability. Sidecar Health bears no responsibility for the accuracy, legality or content of any external websites or for subsequent links from an external site.