We know how important pharmacy benefits are to you—with your plan, you have:

Nationwide access to CVS/caremark network pharmaciesCoverage for most FDA-approved drugs

  • Nationwide access to CVS/caremark network pharmacies
  • Coverage for most FDA-approved drugs
  • Benefits for CVS/caremark mail order and CVS retail pharmacies —get up to a 90 day supply of a maintenance medication at either setting
  • Access to savings on everyday health-care related items through the CVS/caremark ExtraCare® Health Card Program
  • A $200/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 network or out-of-network retail drugstore or 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.
Prescription Drugs – 2022 and 2023 Benefits
RCBP knows how important pharmacy benefits are to you—with your plan, you have:

  • Nationwide access to CVS/caremark network pharmacies.
  • Coverage for most FDA-approved medications.
  • Benefits for CVS/caremark mail order and CVS retail pharmacies —get up to a 90 day supply of a maintenance medication at either setting.
  • Access to savings on everyday health-care related items through the CVS/caremark ExtraCare® Health Card Program.

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) $40 (No deductible) $70 (No deductible)

Specialty Pharmacy

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 866-814-5506.

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)

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

RCBP Pharmacy Resources

Drug Guides

Rx Drug Calculator

To find a participating network pharmacy you will need to register for or login to your Aetna member website.

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