Coronavirus COVID-19 FAQ

Medicare-specific Part D Plan Sponsor FAQ

(for Group MAPD Plans & Fully-Insured and Self-Funded Group PDPs)

Yes. All 50 states have declared some form of emergency triggering our policy liberalization protocol. More specifically:

Contact your group account director to learn more.

Most home delivery fees have been waived for prescriptions purchased from a CVS retail pharmacy. Through August 31, 2020, charges for standard 1-2 day delivery fees are waived. Same-day delivery cost is $7.99.

Yes. But to qualify, the member must have a valid prescription with refills available. State dispensing rules also apply.

Pharmacists can enter a standard submission code when filling the refill, which will allow refill too soon edits from stopping the prescription. They should contact the pharmacy help desk line if they need help.

The member’s plan benefits will indicate the available options for a member to receive a 90-day supply of medication.

  • For drugs on tiers that allow up to a 90-day fill, members can get an early refill of up to another 90-day fill (as long as their prescription has refills remaining).
  • For drugs on tiers with a 30-day benefit limit (such as the specialty tier, if applicable), members can get an early 30-day supply refill and up to two additional 30-day fills, to a maximum of 90 days (as long as their prescription has refills remaining).

But for now, these actions will ensure members have the ability to have medication on hand during social distancing efforts.

At this time there is no limit to the volume of early refill requests that can be made. But to qualify, the member must have a valid prescription with refills available. State dispensing rules also apply.

The member’s plan benefits will indicate the available options for a member to receive a 90-day supply of medication.

  • For drugs on tiers that allow up to a 90-day fill, members can get an early refill of up to another 90-day fill (as long as their prescription has refills remaining).
  • For drugs on tiers with a 30-day benefit limit (such as the specialty tier, if applicable), members can get an early 30-day supply refill and up to two additional 30-day fills, to a maximum of 90 days (as long as their prescription has refills remaining).

Pharmacists are able to enter a standard submission code when filling the refill, which will allow refill too soon edits from stopping the prescription. They should contact the pharmacy help desk line dedicated if they need help.

No. Our early refill policy aligns to the current benefit design in terms of how many days-supply you can get early. Please see your plan benefits for what drugs allow for up to 90-day supplies and which are limited to 30 days.

Yes, however, members will have to pay for their prescription and submit a claim form to get reimbursed. Therefore, we strongly recommend that members use network pharmacies. Members with specific network issues should contact the phone number on their ID card.

We have communication mechanisms within the organization to ensure that our customer representatives are trained and that FAQs are created and distributed to them and updated frequently.

Because each member’s drug therapy and circumstance are unique, our pharmacists and customer care representatives have been trained in all of the available overrides and flexibilities permitted by CMS.

We’ve enabled many employees to work remotely from home. This will help us meet the needs of our members and continue to meet compliance timeframes and guidelines set forth by CMS.

Please note that we have multiple call centers in different areas of the country – both for members and providers. This allows us to move calls, as necessary, to accommodate volume, illness and even weather-related events. In addition, we have back-up centers that are online and ready to serve those who need them.