Frequently Asked Questions

Need to define a word? Check the Glossary for a list of common healthcare terms.

Prescription

  • If you are prescribed a long-term maintenance medication, you should use Maintenance Choice or CVS/Caremark Mail Service Pharmacy by the third fill, or the prescription will be subject to a 50% co-insurance payment and the plan limit on the maximum co-payment per prescription will not apply.

  • 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 limit on 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 in the My Documents section of your Member Dashboard for specific coverage.

  • TeamCare does not cover medication or supplies ordered from outside the United States, covered over-the-counter medications without a prescription, vitamins, or dietary supplements. For a complete listing of non-covered items under your Prescription Benefit, please refer to your Summary Plan Description in the My Documents section of your Member Dashboard.

  • 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.

     

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

  • Yes, for covered medications.

  • You can access your prescription history by visiting Caremark.com.

  • No, there is not a mandatory formulary. A prescription drug formulary is a list of commonly prescribed medications that have been selected by Caremark because of their combination of effectiveness and cost.

    Your doctor should call Caremark or visit caremark.com to learn which drugs are covered under your Prescription Benefit. You should encourage your physician to prescribe preferred medications whenever possible, because drugs not on the formulary will not be covered and will cost you more money.

  • Yes, there is a separate annual out-of-pocket maximum that applies only to injectable medications. Once your out-of-pocket for prescription medications costs reach the annual limit of $1,000, all future injectable medication costs will be paid at 100%. Please refer to your Plan Benefit Profile to find the specific information for your injectable medication coverage and to determine exactly what your Prescription Drug Benefit covers—and doesn’t cover.

  • You can access a mail order prescription form by visiting Caremark.com.

  • Ask your doctor to write a new 90-day prescription and send it to a participating retail pharmacy.

    Members can sign into caremark.com to find an in-network retail pharmacy.

  • Ask your doctor to send a new 90-day supply electronic prescription to CVS Caremark Mail Service Pharmacy. This is the easiest way to get started – CVS Caremark will process and ship the order in 7 to 10 business days.

    You may also sign into caremark.com and select Start Rx Delivery by Mail and CVS Caremark will contact your doctor and get the process started for you. Once we reach your doctor and receive approval, it will take 7 to 10 business days to process and ship your order.

    Note: You cannot access Start Rx Delivery by Mail from the CVS Caremark app. You must access this service from a web or mobile browser.

    If you prefer to mail your prescription you can download and print a Mail Service Order form: Mail Service Order Form - English (pdf)

    Complete and mail the form along with the 90-day prescription and payment to the address shown on the form. You may pay by credit or with a debit card (VISA®, MasterCard®, Discover®, American Express®), check or money order, or electronic check.

    You can also call the Customer Care number (888-483-2650) on your member ID card to have a form mailed directly.

  • Sign into caremark.com to find an in-network retail pharmacy using the pharmacy locator tool.

    You can find the closest available pharmacies in the Retail 90 network for your 90-day fills. Make sure to select the best pharmacies for savings from the Advanced Search menu options when using the Pharmacy Locator Tool.

    Members residing outside Oklahoma (and West Virginia starting on January 1st, 2024) will continue to default to the current network set up (Maintenance Choice) for their long-term medication fills.

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