CVS Caremark
Meeting All Your Prescription Needs
Your Prescription Benefit Plan
Working with CalPERS, 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 on January 1, 2026.
To get started, find the name of your health plan to explore the benefits available to you.
On this page, you can see drug lists for your plan, access important links and documents and view Frequently Asked Questions. You can also explore the Information Center for videos about your plan's tools.
Benefit Plan Options
Effective January 1, 2026, CVS Caremark (CVS) will be your new pharmacy benefits manager (PBM). CVS will manage retail, mail-order, and specialty pharmacy services, offering members an enhanced experience through a nationwide pharmacy network, digital tools, and improved customer service.
Choose from Basic Plans and SilverScript Medicare Plans to get more information.
Basic Plans
SilverScript Medicare Plans
Important Links and Documents
Access important information and documents relating to your plan and benefits.
Contact CVS Caremark Customer Care
Customer Care is available 24 hours a day, 7 days a week.
CalPERS Basic - 1-833-291-3649
CalPERS SilverScript Medicare - 1-833-291-3648
Frequently Asked Questions
General Transition Information
CVS Caremark will be prepared to welcome CalPERS members and dependent(s) who would like to call in and speak with a live representative, beginning on September 15 (Open Enrollment). Representatives will be able to provide members and dependent(s) with more information about their new prescription benefits.
Basic plan members can call CVS Customer Care: 833-291-3649
Medicare plan members can call SilverScript Customer Care: 833-291-3648
A PBM is a third-party vendor that CalPERS contracts with that helps manage your prescription drug benefits for certain health plans. They handle things like processing pharmacy claims, managing the list of covered medications, also known as the “formulary,” negotiating drug prices and providing you tools and programs to help you manage your prescriptions.
The following CalPERS health plans will be impacted:
Basic
- Anthem Blue Cross Traditional HMO
- Anthem Blue Cross Select HMO
- Health Net Salud y Más HMO
- PERS Gold Basic PPO
- PERS Platinum Basic PPO
- Sharp Health Plan Performance Plus HMO
- UnitedHealthcare SignatureValue Alliance HMO
- UnitedHealthcare SignatureValue Harmony HMO
- Western Health Advantage HMO
Medicare
- Anthem Blue Cross Medicare Preferred PPO
- PERS Gold PPO Medicare Supplement
- PERS Platinum PPO Medicare Supplement
The new PBM will take effect on January 1, 2026.
This change is being made to enhance our pharmacy services and better manage your prescription benefits. CalPERS chose CVS Caremark/SilverScript because of its strong commitment to performance guarantees in key areas such as managing pharmacy costs, ensuring clinical quality, and increasing transparency. This change is designed to provide you with high-quality service while ensuring your access to safe and effective medication.
SilverScript is an affiliate of CVS Caremark and will administer pharmacy benefits for our Medicare members.
SilverScript is the Medicare Part D plan name and will administer pharmacy benefits for our Medicare members – the main difference between SilverScript and CVS Caremark is branding.
Yes, the transition information is the same for Basic and Medicare/Silverscript members.
No; all members currently receiving pharmacy benefits through Optum will receive those same benefits through CVS/SilverScript starting January 1, 2026.
No immediate action is needed. Over the coming months, you will receive additional information about your new prescription benefit. You will receive a Welcome Kit that includes a QR code that will allow you to register on Caremark.com and use the CVS Health app.
- Watch for mail from CVS Caremark or SilverScript for Medicare members with information about the formulary, pharmacy network, and ID cards
- Refill any prescriptions as you normally would ahead of the transition, especially if you have a limited supply
- Talk to your doctor if you are concerned about a specific medication
You can call CVS Caremark Member Services to ask general questions about open enrollment and the transition.
Your plan’s formulary will be available for viewing online at www.caremark.com/calpers; or you can call CVS Caremark Member Services to check for information on your plan’s formulary and/or list of covered medications.
Pharmacy Network
CVS Caremark’s retail pharmacy network is national in scope and is comprised of over 64,000 pharmacies, including major chains, regional pharmacies, and independents. While rare, there could be some changes to your retail pharmacy (e.g. due to pharmacy closures, etc.). In the coming months, members will receive a letter notifying them if they will experience any pharmacy network changes. Additionally, members will also have access to CVS Caremark’s web site that will allow you to research whether a specific pharmacy will be in network.
CVS will notify members who may experience changes to their network pharmacy. You will receive detailed information if impacted.
Most retail pharmacies will remain accessible through CVS Caremark. If your pharmacy is impacted, you will receive a letter notifying you of the change approximately 30-60 days prior to the effective date of January 1, 2026. In addition, Members can utilize the Pharmacy Locator tool at www.caremark.com/calpers during Open Enrollment to confirm network pharmacy status.
You can locate a list of pharmacies in your network by using the Pharmacy Locator tool for your plan.
Prescription Transition
To find out if your medicine is covered, you can use our Check Drug Cost and Coverage tool under your plan. Fill in the requested information about the medicine and dosage and you'll receive a message telling you if your medicine is covered and what your co-pay amount will be. You'll also find out if there is a generic or a preferred medicine available that can help save you money.
In most cases, you will continue to fill prescriptions at your preferred retail pharmacy (e.g. CVS, Walgreens, Safeway, VONS, etc.) as you do today. However, there may be some changes to the list of covered drug or changes to in-network pharmacies. Additionally, mail order prescriptions and specialty pharmacy prescriptions will be dispensed through CVS Caremark pharmacies, instead of OptumRx pharmacies.
Non-controlled prescriptions with refills remaining that are currently filled at OptumRx mail and specialty pharmacies will automatically transfer to CVS Caremark. Some prescriptions may require a new prescription from your doctor, such as controlled substances or expired refills. CVS will notify you prior to the effective date if action is needed.
Some medications may have different approval requirements under the new PBM. If you currently have an active approved prior authorization, it will transfer automatically to CVS.
Yes. The mail order pharmacy will change, but mail order delivery will continue to be an option. Most mail order prescriptions will transfer automatically, and you will receive instructions on how to place your first fill.
Many prescriptions will be transferred automatically to the new mail order pharmacy (CVS Caremark). Some prescriptions may require a new prescription from your doctor, such as controlled substances or expired refills. You will be notified prior to the effective date if action is needed.
For prescriptions that can’t be transferred, such as Controlled Substances and prescriptions with no remaining refills, please contact your prescriber or CVS Caremark if you are in a Basic plan or SilverScript if you are in Medicare.
Yes, you will need to provide your new ID card to the pharmacy.
Your physician can request a medical necessity exception for your medication if it is no longer covered but they believe it is the most effective medication for your condition. Additionally, for Basic plans, if you need more time to make a change from your excluded drug to a preferred medication, members can call into CVS's dedicated team and request a 90-day transition fill. For Medicare plan members impacted by the formulary change, there will be a 90-day transition period for filling prescriptions, prior to being switched to an equally safe and effective alternative medication.
Yes; for Basic plan members, specialty medications will now be filled through CVS Specialty pharmacies.
Formulary Changes
If impacted, you will receive detailed information approximately 30-60 days prior to the effective date of January 1, 2026.
There may be updates to the formulary, including changes to covered medications. If your medication is impacted, you will be notified by letter and provided additional information, including alternative options, to discuss with your doctor.
Yes; all medications that may be excluded will have an equally safe and effective alternative medication on the new formulary.
No, the plan’s pharmacy co-payments for 2026 will remain the same. However, due to formulary changes, some drug coverage and cost share may be different, which could impact your out-of-pocket cost.
A formulary change refers to modifications made to the list of covered prescription drugs, known as the formulary. These changes can involve adding, removing, or reclassifying drugs, as well as adjusting prior authorization or step therapy requirements.
If your medication is affected by a formulary change – for example, no longer covered or moved to a higher tier – you will receive a personalized letter approximately 30-60 days before the effective date of January 1, 2026. This letter will include:
- Covered alternatives
- Next steps if you need to request a formulary exception
- How to speak with your doctor about switching medications
Member Support
You will receive information about how to access important information online at www.caremark.com/calpers and through the CVS Health app, including tools like a pharmacy locator search feature to find in-network pharmacies.
No, most members will not experience any disruption from this change. Your current pharmacy benefits will continue as usual.
Basic plan members will receive a new member ID card from their health plan with updated pharmacy information.
Medicare members will receive a new member ID card from SilverScript.
You will receive a new ID card a few weeks before January 1, 2026. Please be sure to monitor your mailbox and use this card for all prescription services starting on January 1, 2026.
