State of New Hampshire Pharmacy Benefit Changes Effective 10/1/2010 Presented By: Melisa Briggs

Pharmacy Benefit Overview There are two ways you can obtain your prescription medications through CVS Caremark: Mail Order Program – To order prescriptions used on a regular basis (such as blood pressure, allergy) Retail Pharmacy Program – To purchase medications needed for a short-term basis or if medications are needed quickly (such as antibiotics)

Pharmacy Benefit Overview and Changes Effective 10/1/2010 *$500 Individual/$1,000 Family calendar year out-of pocket maximum; once this is met you will have a zero copay and 100% coverage for the remainder of the calendar year. Retail and mail order copays apply towards this maximum. Active Employees and RetireesGenericPreferred Brand-Name Non-Preferred Brand-Name Retail Pharmacy (co-payment per prescription or refill for up to a 31-day supply); refill limit of up to three fills (one initial plus two refills) for maintenance or long-term medications $5$10$15 Mail Order (co-payment per prescription or refill for up to a 90-day supply) $1$20$30

Mail Order Prescriptions – What You Should Know You and the State’s Prescription Benefit Program save money when you order maintenance or long- term prescriptions through mail order – This is due to the cost savings received when prescriptions are filled through CVS Caremark’s Mail Service Pharmacy Beginning 10/1/2010, all maintenance or long- term prescriptions will be filled through CVS Caremark’s Mail Service Pharmacy

Mail Order Prescriptions – What You Should Know To allow you time to transition to mail order for your current maintenance or long-term prescriptions – You may fill these for up to three fills (one initial plus two refills) on or after 10/1/2010 If after three fills at the retail pharmacy you choose to fill your maintenance or long-term prescriptions at the retail pharmacy – You will pay 100% of the cost – You should still present your CVS Caremark identification card in order to receive CVS Caremark’s discounted price – This cost will not be applied to your calendar year out-of-pocket maximum

Mail Order Prescriptions – What You Should Know For any newly prescribed maintenance or long- term prescriptions that you fill on or after 10/1/2010 – You may fill up to a 31-day supply for up to three fills (one initial plus two refills) at a retail pharmacy location

Mail Order Prescriptions – What You Should Do  Look for a letter from CVS Caremark explaining how to use the mail order pharmacy – You will receive this letter if you are currently filling your maintenance or long-term prescriptions at the local retail pharmacy – Ongoing notification will be sent if you have not transferred to mail order, or when you fill a new maintenance or long-term prescription

Mail Order Prescriptions – What You Should Do  Take advantage of the cost savings and convenience right away! – You do not have to wait until on or after 10/1/2010 to begin using the mail order program to fill your maintenance or long-term prescriptions

Mail Order Prescriptions – Did You Know? Using the mail order vs. retail pharmacy will save you time and money – It’s convenient and an easy way to obtain your prescriptions  New Prescriptions – 7 to 10 days after CVS Caremark receives your order  Refills – 5 to 7 days after CVS Caremark receives your request – You will save money  For example, if you are taking a preferred brand-name medicine you will pay $20 for a 90-day supply through the mail order; the cost would be $30 at the retail pharmacy for the same supply

Mail Order Prescriptions – Did you know? Doctors can fax prescriptions directly to CVS Caremark by calling FastStart Program – To get started call , or log on to and click on “Start a New Prescription”, then click “FastStart” – Provide the name of your medication, doctor’s name and phone – CVS Caremark will contact the doctor for you to obtain a new prescription

Mail Order Prescriptions – Did you know? Future refills can be ordered - Online at there is a one-time online registration that only takes a minute or twowww.caremark.com - Call toll-free and use the automated refill service - Complete the “Mail Service Order Form” and send directly to CVS Caremark New Mail Order Features – Automatic Refills and Renewals

Mail Order Prescriptions – Did you know? Brand name prescriptions will automatically be substituted with a generic equivalent if available, unless your doctor indicates “dispense as written” or similar instructions Registered pharmacist are available for consultation 24 hours a day, seven days a week, by calling CVS Caremark Delivery will always be free – even if there is special shipping requirements

Mail Order Prescriptions – Did you know? You can request an additional supply of medication by calling CVS Caremark if you will be traveling for a long period of time Specific procedures are followed in the rare event your medication is lost, stolen or damaged CVS Caremark’s mail order pharmacies have the appropriate quality and safety procedures in place when shipping medications

Retail Pharmacy Prescriptions – What You Should Know You can continue to use retail pharmacy locations for: – Your short-term prescription needs – Other types of non-maintenance medications, such as sleep agents and pain relief prescriptions – Compound medications You can go to any participating pharmacy and do not need to use a CVS pharmacy Just show your CVS Caremark ID card and pay the applicable copay

Specialty Drug Program - What You Should Know Specialty medications are used to treat chronic and/or genetic conditions, such as multiple sclerosis and rheumatoid arthritis – Often infused or injected medications Beginning 10/1/2010, all specialty medication will be provided by CVS Caremark’s Specialty Pharmacy CVS Caremark’s Specialty Pharmacy is a mail order facility dedicated to dispensing specialty medications

Specialty Drug Program - What You Should Know This program is designed to provide you with personalized care, education and support – Access to a pharmacist 24 hours a day, seven days a week – Coordination of care with you and your doctor – Convenient delivery directly to you or your doctor’s office – Medicine- and disease-specific education and counseling – Online support through including interactive areas to submit questions to pharmacists and nurseswww.caremark.com/specialty

Exclusive Specialty Drug Program - What You Should Do  Look for a letter from CVS Caremark explaining how to enroll in the Specialty Drug Program – You will receive this letter if you are currently taking specialty medication(s) and purchasing them through a retail pharmacy  You should contact CVS Caremark Specialty Pharmacy at if you are newly prescribed a specialty medication

Generic Equivalent Program – What You Should Know You and the State’s Prescription Benefit Program save money when you use generic equivalents – Generic medications often cost much less Beginning 10/1/2010, if you request a brand- name medication when the generic equivalent is available – You will pay the generic copay plus the difference in cost between the generic and brand-name medication – This additional cost will not be applied to your calendar year out-of-pocket maximum

Generic Equivalent Program – What You Should Know When your doctor recommends the brand-name medication for your treatment – Your doctor will indicate “Dispense as written” or similar instructions – You will pay the brand-name copay

Generic Equivalent Program – What You Should Do  Look for a letter from CVS Caremark explaining which medications have generic equivalents – You will receive this letter if you are currently filling your prescription(s) with a brand-name medication when a generic equivalent is available – It will include the steps to take to avoid paying the added cost of the brand-name medication

Generic Equivalent Program – What You Should Do  Talk with your doctor to determine if the generic equivalent is appropriate for you  Ask for a new prescription from your doctor if you would like to change to the generic medication

Generic Prescriptions – Did You Know? Taking generics will save you money  The copay for generic medicine will always be less than the brand name copay  Generics are FDA*-approved equivalents of their brand counterparts and cost less  Generics typically cost 30-80% less than the brand name  The FDA reviews generics to make sure they are safe, the same ingredients, strength, dosage form and performance (how it works in the body) *U.S. Food & Drug Administration

Other Pharmacy Benefit Program Enhancements – Effective 10/1/2010 New Generic Mail Order Copay – Your copay for all generics will be reduced to $1 when you use the mail order pharmacy  Discuss generic alternatives with your doctor  Obtain a new prescription if the generic medication is appropriate for you

Other Pharmacy Benefit Program Enhancements – Effective 10/1/2010 New Coverage for Physician-Prescribed Tobacco Treatment Medications and Over-the-Counter (OTC) Medications You may purchase tobacco treatment prescriptions and over-the counter medications to help you quit using tobacco products – Nicotine Replacement Therapy Patches, Gum, and Lozenge – Bupropion – Zyban – Nicotrol Nasal Spray – Nicotrol Inhaler – Varenicline – Chantix

Other Pharmacy Benefit Program Enhancements – Effective 10/1/2010  Discuss your desire to stop using tobacco products and treatment options with your doctor  Ask if a prescription or OTC medications would help you with your quit attempt – A prescription is also required for all OTC medications  Present your CVS Caremark prescription ID card with your prescription at the local retail pharmacy, or use the mail order program

Other Pharmacy Benefit Program Enhancements – Effective 10/1/2010  The same copays apply to tobacco treatment medications and OTC medications as all other prescription copays  Covered dependents age 17 and younger are not eligible for these medications  Ask your doctor if participation in a group or individual tobacco dependence counseling program would also be of help with your quit attempt

Other Pharmacy Benefit Program Enhancements – Effective 10/1/2010 Dependence counseling programs available  Your Employee Assistance Program – Call , ext  NH Smokers’ Helpline 800-Try-To-STOP ( )  Other group counseling programs are also offered in your local community, hospital and workplace setting

Other Communications – What You Should Know Look for a personalized prescription drug benefit booklet in the mail that will provide – Information about your prescription drug benefits and how to make the best use of them – A convenient pull-out guide outlining plan specifics You will not receive new prescription ID cards – Continue using your current ID cards when purchasing prescriptions at the retail pharmacy

What is covered under your pharmacy benefits? State-restricted drugs (i.e. cough syrups with codeine) Diabetic supplies, including insulin syringes Insulin by prescription only Federal legend Drugs, including: -Cardiovascular Drugs -Anti-infectives -Dermatological Therapies -Ear, nose and throat medications -Ophthalmology drugs -Respiratory, allergy, cough, and cold medications -Oral diabetic drugs -Growth hormones and injectables

What is covered under your pharmacy benefits? Compound medications Birth control devices and oral contraceptives Immunizing agents Tobacco treatment medications and over-the-counter medications (effective 10/1/2010)

What is not covered under your pharmacy benefits? Therapeutic devices or appliances (i.e. bandages, humidifiers) Non-federal legend drugs, except insulin (i.e. over-the-counter medications) Anti-Obesity Medications Drugs labeled “Caution-Limited by Federal Law to Investigational Use,” or experimental drugs Medication for which the cost is recoverable under any workers’ comp or occupational disease law, any state or government agency, or medication furnished by any other pharmaceutical or medical service for which no charge is made to the individual Medication taken or administered to the member while he or she is inpatient Any prescription that has reached the maximum number of refills specified by the physician or any prescription that is more than 1-year old

Questions?