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Q. How will I know if my pharmacy is no longer able to fill my prescription?
A. On or after November 1, 2009, you can log on to www.caremark.com/ers and use the Pharmacy Locator tool to see if your pharmacy is participating. You may also call Caremark Customer Care toll free at (888) 886-8490 and a representative will help you find an in-network pharmacy.
Q. How do I find an alternative in-network pharmacy?
A. Log on to www.caremark.com/ers and use the Find a Local Pharmacy tool to find a participating pharmacy near you. Or, you may call Caremark Customer Care toll free at (888) 886-8490 and a Customer Care Representative will help you.
Q. How do I transfer my prescription if my current pharmacy is no longer participating starting November 1, 2009?
A. Transferring a prescription is easy. Each pharmacy’s requirements may be different, so check with the new pharmacy on how to transfer your prescription. In many cases, the new pharmacy will need only the information on your prescription bottle.
Q. What if I want to continue to use my current pharmacy even though it is no longer in the network?
A. If you use a non-participating pharmacy, you will have to pay the full amount at the time of purchase and then file a paper claim for reimbursement. You will need your receipt to file a paper claim. The amount of the reimbursement will be 60 percent of the remaining balance of the lesser of: 1) the usual and customary price of the drug minus your deductible (if not met) and your copayment; OR 2) the ERS contract price of the drug minus your deductible (if not met) and your copayment.
Please note that if you get a brand-name medication that has a generic equivalent available, you are also responsible for the difference in cost between the generic and preferred or non-preferred brand name drug, in addition to paying the generic copayment.
You will see a much lower out-of-pocket expense by using a participating pharmacy. Call Customer Care toll free at (888) 886-8490 for the name and location of a participating pharmacy to avoid additional non-participating pharmacy costs.
Q. Is it possible for my current pharmacy to re-join the network after November 1, 2009, if they originally left the network?
A. Yes, your current pharmacy would need to contact Caremark to initiate the process for contracting with that pharmacy.
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