Rx

What does my TeamCare Prescription Benefit cover?

The TeamCare Prescription Drug Benefit covers charges for eligible drugs prescribed by a physician or dentist dispensed by a pharmacist and not available over the counter without a prescription. 

How much does TeamCare pay under my TeamCare Prescription Benefit?

Retail Pharmacy Store: Under the Retail Pharmacy program, you pay a coinsurance per fill.

Maintenance Choice/Mail Order Pharmacy: Under the Caremark Mail Service Pharmacy or Maintenance Choice, you pay a co-insurance per fill. Under Maintenance Choice, the patient can receive a 90-day supply of medication at a local CVS pharmacy store.

Do I have to use mail order?

If by the third fill, long-term maintenance medications are not filled through the CVS/caremark Mail Service Pharmacy or Maintenance Choice, they are subject to a 50% co-insurance if filled through the Retail Card Program.

Do I have to use generic medications?

If you purchase a brand-name drug when a generic equivalent is available, you will pay your generic co-insurance plus the difference in cost between the brand-name and the generic drug. The maximum co-payment per prescription does not apply for brand-name drugs when a generic equivalent is available. Please refer to your Plan Benefit Profile for specific coverage (Forms and Documents or your Participant Dashboard).

What is not covered under my TeamCare Prescription Benefit?

TeamCare does not cover medication or supplies ordered from outside the United States, over the counter medications, vitamins or dietary supplements. For a complete listing of non-covered items under your Prescription Plan, please refer to your Summary Plan Description (Forms and Documents or your Participant Dashboard).

How do I file a prescription claim if I didn’t use the TeamCare Prescription Benefit?

You will need to submit itemized receipts from your pharmacy to:

TeamCare
A Central States Health Plan
P. O. Box 5116
Des Plaines, IL 60017-5116

Consult your TeamCare Benefit ID card and make sure that all information is accurate on the claim.

Why was my or my family member’s prescription rejected for coverage?

There are many reasons a prescription is rejected, such as a problem with eligibility, trying to get a non-covered drug or other insurance. Ask the pharmacy why the prescription was rejected and contact the Plan for assistance.

Where do I find a form for Caremark Mail Service Pharmacy?

You can access a mail order prescription form by visiting Caremark.com or use the link here on our site to go to their website. You may also contact the Plan to request that a copy be sent to you.

Will you cover a prescription from my dentist?

Yes, for covered medications.

Does TeamCare cover drugs related to the treatment of erectile dysfunction?

No, not at this time.

Do I need my TeamCare Benefit ID card to get a prescription filled?

We suggest carrying your TeamCare Benefit ID card at all times.

How do I get a copy of my prescription history?

You can access your prescription history by visiting Caremark.com or use the link here on our site to go to their website.

How do I locate a CVS pharmacy near me?

To locate a CVS pharmacy visit CVS.com or call Customer Care at 888-483-2650.