Prescription Drugs

When you enroll in a Conduent medical plan, you automatically get prescription drug benefits that help you pay for the medications you need.

Classic PPO Plan and Consumer Choice Plans through Anthem

For the Classic PPO Plan and Consumer Choice Plans through Anthem, prescription drug benefits are provided through CVS/Caremark. Here’s how it works.

  • For the Classic PPO Plan, there’s no deductible to meet. You and the plan share costs (coinsurance), with a maximum amount that you’ll need to pay.

  • For the Consumer Choice Plans, you must first meet the medical deductible. Then, you and the plan share costs (coinsurance), with a maximum amount that you’ll need to pay. For certain preventive drugs, you don’t need to meet the deductible first. See the preventive drug list here.

Short-Term Prescriptions

The CVS Caremark pharmacy network has more than 50,000 pharmacies nationwide, including 7,600 CVS pharmacies plus Walmart, Target, and many other national and independent retail pharmacies. You can use a pharmacy outside the CVS Caremark network, but you’ll save money if you use participating in-network pharmacies. Find an in-network pharmacy at caremark.com.

Note: Walgreens and Rite Aid are considered out-of-network pharmacies.

Long-Term Prescriptions

Mail order is required for maintenance medications (medicines taken regularly for chronic conditions, such as high blood pressure, asthma, diabetes, or high cholesterol).

  • You have two ways to fill your 90-day maintenance medication prescription:

    • CVS Caremark Mail Service Pharmacy or

    • CVS Caremark Maintenance Choice, which allows you to fill your 90-day prescription at a local CVS Pharmacy.

  • After an initial fill and two refills of maintenance medications (for a total of three fills), you must use the CVS Caremark Mail Service Pharmacy or a CVS Pharmacy.

  • You will pay 100% of the cost of maintenance medications if you purchase a 30-day supply at a retail pharmacy after three fills.

 

What’s Ahead for 2025

Consumer Choice Plans

There are no prescription drug plan design changes for 2025. The prescription drug benefits are the same for the 2000/4000 Deductible Plan and the 4000/8000 Deductible Plan.

Classic PPO Plan

There are no prescription drug plan design changes for 2025.

Step Therapy

In some cases, your doctor may need to prescribe a lower-cost medication as the first step in treating your health condition. This is called step therapy. The Classic PPO plan and Consumer Choice Plans use step therapy to help manage prescription drug costs for you and the plan.

If step therapy applies to you and you use certain higher-cost medications before the available lower-cost options, your current prescription may not be covered. This means you may have to pay the full cost. If your doctor does not think a lower-cost medication is right for you, ask them to contact CVS Caremark at 1.855.559.1385.

Vaccinations

For the Classic PPO plan and Consumer Choice Plans, certain vaccinations are covered at participating pharmacies at 100%. This includes flu shots as well as other vaccinations like measles, mumps, rubella, tetanus, and pneumonia.

Limited Coverage Plan

Prescription drug benefits are provided through Anthem.

  • You pay a set copay for generic drugs.

  • For brand drugs, you and the plan share costs.

  • Non-preferred brand drugs are not covered.

If you have questions, contact Anthem at 1.833.485.1232 or visit anthem.com. For more details, see the Summary of Benefits and Coverage (SBC) on BenefitsWeb.

Prescription Drug Benefits at a Glance

Here’s a look at what you’ll pay when you need care.

Classic PPO and Consumer Choice Plans

Limited Coverage Plan

Kaiser Permanente, Hawaii, and Puerto Rico

Prescription drug coverage is provided through the plan. Please see the Summary of Benefits and Coverage (SBC) on BenefitsWeb for more details. You can also contact the plan administrator: