How to Use Your Drug Plan

This how-to guide can help you achieve the lowest cost for your prescription drugs.

1. Understand CareFirst's three-tier prescription drug program:

   In most plans, prescription drugs fall into one of three tiers. The tiers represent the level of cost that a member will pay.

   • Preferred Drugs are:
     • Tier 1 - Generic Drugs: lowest copay ($)
     • Tier 2 - Preferred Brand Name Drugs: middle copay ($$)

   Note: Self-administered drugs may have a coinsurance payment.

   • Non-Preferred Drugs are:
     • Tier 3 - Non-Preferred Brand Name Drugs: highest copay ($$$)
       
   
   
2. Learn what drugs are on the preferred drug list (Tier 1 and Tier 2)
   • Enter a drug name in the search field of the prescription drug database. The search results field will provide tier information.
   • Print a complete copy of the preferred drug list (Tier 1 and Tier 2 drugs)
     
     
3. Talk to your doctor
   • Bring a printable copy of the preferred drug list with you on your visit to the doctor.
   • Discuss if a preferred drug is right for you.
     
     
4. Fill or refill your prescription through:
   • Local Pharmacy
     • Bring your prescription and member ID card to one of more than 59,000 participating pharmacies nationwide.
     • Pay the appropriate copayment or coinsurance.
     • Once your deductible has been met (if applicable to your plan), you will pay a different amount for drugs depending if you use generic, preferred brand name or non-preferred brand name drugs.
     • Some plans may require a coinsurance payment for certain self-administered injectable drugs.
     • Receive up to a 34-day supply of medication, although some members may receive a 35-90 day supply of maintenance drugs from a participating retail pharmacy.
   • The mail order program:
     • Is beneficial for anyone on maintenance medications since it's convenient and may save you money.
     • To order new prescriptions, you will need to fill out the Walgreen's order form (PDF).
     • Once received, your prescription is reviewed and dispensed by a registered pharmacist and mailed directly to your home.
     • Call Walgreen's Mail Order at 1-800-745-6285 for more information or visit Walgreen's Mail Service.