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Rural Carrier Benefit Plan
Providing superior service to rural letter carriers nationwide

Prescription benefits overview

2024 Plan year: Prescription and pharmacy benefits information

Your medicine is important

The RCBP High Option health plan includes comprehensive prescription drug coverage. And offer tools and guidance to help you find covered medicine and understand your costs.

This means you can get access to nationwide network pharmacies, low copays for generic medications and mail-order pharmacy services. Our prescription drug plans offer tools and guidance to help you find covered medicine and understand your costs.

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RCBP knows how important pharmacy benefits are to you—with your plan, you have:

  • Nationwide access to CVS Pharmacy® stores
  • Coverage for most FDA-approved drugs
  • Benefits for CVS Caremark Mail Service Pharmacy and CVS Pharmacy stores — obtain up to a 90-day supply of a maintenance drug at either location
  • A $200 per person retail-only calendar year prescription drug deductible*

* This deductible is separate from the plan’s calendar year deductible. It applies only to prescriptions that you buy at any retail pharmacy.

Note: The $200 deductible for prescriptions purchased at a network retail pharmacy does not apply when you have Medicare Parts A and B as primary coverage.

Mail order pharmacy

Ask your doctor to consider prescribing medications from your Prescription Drug Guide/Formulary drug list when medically appropriate. To help save you money, ask if a generic medication is available.

You may also order your prescriptions by mail, internet or phone.

Mail order and Retail pharmacy information

2024 Prescription benefits

(when Medicare is not primary)

2024 Non-specialty Pharmacy

Pharmacy Tier I (Generic) Tier II (Brand Name on primary drug list) Tier III (Brand Name not on primary drug list)
Network Retail Pharmacy (up to a 34-day supply) 30% of cost*; maximum $7.50 per prescription 30% of cost*; maximum $200 per prescription 30% of cost*; maximum $200 per prescription
Network Retail Pharmacy, Medicare Part B primary (up to a 34-day supply) 30% of cost (No deductible); maximum $7.50 per prescription 30% of cost (No deductible); maximum $200 per prescription 30% of cost (No deductible); maximum $200 per prescription
Out-of-Network Retail Pharmacy (up to a 34-day supply) 30% of cost* 30% of cost* 30% of cost*
Out-of-Network Retail Pharmacy, Medicare Part B primary (up to a 34-day supply) 30% of cost (No deductible) 30% of cost (No deductible) 30% of cost (No deductible)
CVS Retail Pharmacy or CVS Caremark mail service (up to 90-day supply) $10 (No deductible) $50 (No deductible) $80 (No deductible)
CVS Retail Pharmacy or CVS Caremark mail service, Medicare Part B primary (up to 90-day supply) $10 (No deductible) $50 (No deductible) $80 (No deductible)

Note: A generic equivalent will be dispensed if it is available, unless your physician specifically requires a brand name drug.

* Calendar year pharmacy deductible applies.

Note: This deductible is separate from the plan’s calendar year deductible. It applies only to prescriptions that you buy at any retail pharmacy. The $200 deductible for prescriptions does not apply when you have Medicare Parts A and B as primary coverage.

** Specialty Drugs

2024 Specialty Pharmacy

Pharmacy Tier IV (Specialty generic drugs) Tier V (Specialty preferred brand drugs) Tier VI (Specialty non-preferred brand drugs)
CVS Caremark Specialty Pharmacy 30-day supply (includes when Medicare Part B coverage) $70 (No deductible) $90 (No deductible) $120 (No deductible)
CVS Caremark Specialty Pharmacy, 90-day supply (includes when Medicare Part B coverage) $100 (No deductible) $125 (No deductible) $250 (No deductible)

Specialty drugs are used to treat chronic complex conditions and require special handling and close monitoring and must be obtained from CVS Specialty® pharmacy.

Note: Preauthorization is required. Call CVS Specialty pharmacy at 1–866-814-5506 (TTY:711).

Note: * Calendar year pharmacy deductible applies

* A generic equivalent will be dispensed if it is available, unless your physician specifically requires a brand name drug.
** Specialty Drugs

Tips for using your prescription benefits:

  • Ask your doctor to consider prescribing medications from your Prescription Drug Guide/Formulary drug list when medically appropriate. To help save you money, ask if a generic medication is available.
  • Fill your prescriptions at a network pharmacy.
  • Renew prescriptions before you run out of your medication, or ask us about our Auto Refill or Renewal Programs.
  • Use Vaccine Network pharmacies to get your flu shot and other covered immunizations — you’ll pay nothing.*
  • To find a participating network pharmacy you will need to register for or login to your Aetna member website
Find a Network Pharmacy

Remember: Certain drugs require preauthorization. Current listings of these drugs are available below. Refer to Section 5(f) of the official Plan brochure for more details on your prescription drug coverage.

*Please note: RCBP offers a Vaccine Network Pharmacy Program that covers seasonal and non-season vaccines, please refer to Section 5(f) of the official Plan brochure for more details.

Talk to a nurse anytime

Nurses are available to answer general medication questions at no cost to you anytime at 1-800-556-1555 (TTY: 711). Select the option to speak to a nurse.

2024 Non-specialty Pharmacy 

Pharmacy Tier I (Generic) Tier II (Brand Name on primary drug list) Tier III (Brand Name not on primary drug list)
Network Retail Pharmacy (up to a 34-day supply) 30% of cost*; maximum $7.50 per prescription 30% of cost*; maximum $200 per prescription 30% of cost*; maximum $200 per prescription
Network Retail Pharmacy, Medicare Part B primary (up to a 34-day supply) 30% of cost (No deductible); maximum $7.50 per prescription 30% of cost (No deductible); maximum $200 per prescription 30% of cost (No deductible); maximum $200 per prescription
Out-of-Network Retail Pharmacy (up to a 34-day supply) 30% of cost* 30% of cost* 30% of cost*
Out-of-Network Retail Pharmacy, Medicare Part B primary (up to a 34-day supply) 30% of cost (No deductible) 30% of cost (No deductible) 30% of cost (No deductible)
CVS Retail Pharmacy or CVS Caremark mail service (up to 90-day supply) $10 (No deductible) $50 (No deductible) $80 (No deductible)
CVS Retail Pharmacy or CVS Caremark mail service, Medicare Part B primary (up to 90-day supply) $10 (No deductible) $50 (No deductible) $80 (No deductible)

* A generic equivalent will be dispensed if it is available, unless your physician specifically requires a brand name drug.
** Specialty Drugs

2024 Specialty Pharmacy

Pharmacy Tier IV ( Specialty generic drugs) Tier V (Specialty preferred brand drugs) Tier IV (Specialty non-preferred brand drugs)
CVS Caremark Specialty Pharmacy 30-day supply (includes when Medicare Part B coverage) $70 (No deductible) $90 (No deductible) $120 (No deductible)
CVS Caremark Specialty Pharmacy, 90-day supply (includes when Medicare Part B coverage) $100 (No deductible) $125 (No deductible) $250 (No deductible)

Specialty drugs are used to treat chronic complex conditions and require special handling and close monitoring and must be obtained from CVS Specialty® pharmacy.

Note: Preauthorization is required. Call CVS Specialty pharmacy at 1–866-814-5506 (TTY:711).

* A generic equivalent will be dispensed if it is available, unless your physician specifically requires a brand name drug.
** Specialty Drugs

Prescription drug coverage resources

Are generic drugs really as good as brand names?

You might wonder if generic drugs are as good as brand-name ones. You might think that generic drugs are lower in quality and not as effective as brand-name drugs. This is not true. Generic drugs are:

  • Safe and effective – The U.S. Food and Drug Administration (FDA) holds generic drugs to the same standard as their brand-name alternative. They must have the same active ingredients, be equivalent in strength and dosage, and meet the same standards for safety, purity and effectiveness as the original brand-name product.
  • Cost-effective – You save money when you choose generic drugs over brand-name drugs.

The fact is, generic drugs work just as well as brand-name drugs, but cost less. And generics are available for many brand-name drugs. So when you need a new prescription, ask your doctor if a generic equivalent can be prescribed.

Value Plan Cost Calculator

Standard Option Cost Calculator

Standard Option (Medicare A&B Primary) Cost Calculator

Consumer Option Self Only Cost Calculator

Consumer Option Self and Family Cost Calculator

CVS Caremark, on behalf of RCBP administers your prescription benefit plan. Be sure to share the Prescription Drug Guides with your doctor when a drug is prescribed. If you have questions about your prescription benefit plan, call 1-800-292-4182 (TTY:711).

  • RCBP’s formulary/drug guide is an important part of your prescription benefit program. The list includes preferred and non-preferred brand name drugs. Please note that the list changes quarterly and is not meant to be a complete list of drugs covered under your plan.
  • The drugs in the Prescription Drug Guides have been reviewed by members of the CVS Caremark Pharmacy and Therapeutics Committee, composed of doctors and pharmacists. Drugs are assigned to a category based on their clinical effectiveness, safety and cost. The categories offer you a choice of medications, but the cost to you may vary depending on the category into which the medication is placed.
  • Your prescription benefit plan may not cover certain products, even if they appear in the Prescription Drug Guide. Please check your prescription benefit plan to review coinsurance, exclusions and limitations.
  • The drug guide is not intended as a substitute for your doctor’s professional judgment. It’s offered as a tool to help you and your doctor treat your condition and control your medical costs. If you have questions about how your prescription benefit plan works, just call us using the toll-free number listed on your ID card.

 

Prescription Drug Guide/Formulary

Advanced Control Specialty Formulary

Formulary Exclusion Drug List

  • For help with any of these prescription drug resources, please call CVS Caremark® at 1-800-292-4182 (TTY: 711).

Have questions? We’re here.

Call 1-800-638-8432 (TTY: 711)

Monday–Thursday, 8 AM–5:30 PM ET and Friday, 8:30 AM–5:30 PM ET

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Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). This is a brief description of the features of this RCBP plan. Before making a final decision, please read the Official Plan brochure. All benefits are subject to the definitions, limitations and exclusions set forth in the Official Plan brochure. 

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