About CVS Caremark
Working with your benefits plan sponsor, CVS Caremark provides convenient and flexible options for the prescription drugs you and your family may need. We are here to guide you through the open enrollment process, and to help you understand your plan so you can save time and money when your benefits plan starts.
Check Drug Costs – New York Individual and Small Group Plans
How much will you pay? Use the search tool below to view the amount paid per prescription for a sample Individual or Small Group plan sold directly from MVP Health Care or through the New York State of Health Marketplace™.
2025
This search of a sample plan returns the amount paid per prescription with the co-pay tier structure, deductibles and out-of-pocket maximums described below.
- $10 Tier 1 (generics)
- $35 Tier 2 (formulary brands and some generics)
- $70 Tier 3(non-formulary brands)
- 50% coinsurance Diabetic drugs and supplies
- Deductible is $5,500 individual or $11,000 family
- Out-of-pocket Maximum, is $8,050 individual or $16,100 family
- Insulin is $0 (bypasses deductible)
2024
This search of a sample plan returns the amount paid per prescription with the co-pay tier structure, deductibles and out-of-pocket maximums described below.
- $10 Tier 1 (generics)
- $35 Tier 2 (formulary brands and some generics)
- $70 Tier 3 (non-formulary brands)
- 50% coinsurance Diabetic drugs and supplies
- Deductible is $6,100 individual or $12,200 family
- Out-of-pocket Maximum, is $7,150 individual or $14,300 family
The plan you choose may have prescription drug coverage with different co-pays/co-insurance, deductibles and out-of-pocket maximums.
If you need additional help determining cost sharing information for your medication list please call (800) 378 9295.
Find a Pharmacy in Your Area
Discover which pharmacies will accept your coverage with our Pharmacy Locator. To find a pharmacy near you, follow the directions provided with the Pharmacy Locator
Covered Drug List (Formulary)
Disclaimer: The formulary is subject to change at any time. Refer to your Plan documents for coverage and exclusions. The results of the drug cost check is accurate as of the date checked.
Contact Customer Care
Call us toll free at 1-866-284-7134
Monday through Friday 6:30 am - 9:00 pm CST
Saturday 8:00 am -8:00 pm CST
Sunday 8:00am - 4:30 pm CST
