About CVS Caremark
CVS Caremark works with the EUTF to provide prescription drug plan options for you and your family. Read more about your plan options, formulary, pharmacy network, and utilization management below.
Plan Options
Review a summary of your prescription drug plan.
EUTF
- Actives (effective 7/1/2026)
- Pre-65 Retirees (effective 1/1/2027)
- Pre-65 Retirees (effective 1/1/2026)
- Medicare Retirees
HSTA VB
- Actives (effective 7/1/2026)
- Pre-65 Retirees (effective 1/1/2027)
- Pre-65 Retirees (effective 1/1/2026)
- Medicare Retirees
Specialty Medications: Specialty medications for complex chronic conditions require prior authorization and can be covered under either the EUTF HMSA medical plan or CVS prescription drug plan. Your benefit depends on the medication prescribed, where the medication is dispensed, and plan design. More information can be found in the Specialty Drug Benefit flyer.
Diabetic Supplies: Diabetic supplies, including continuous glucose monitors and disposable insulin pumps, require prior authorization and can be covered under either the EUTF HMSA medical plan or CVS prescription drug plan. Your benefit depends on the product prescribed, where the product is dispensed, and plan design. More information can be found in the Diabetic Supply Benefit flyer.
Formulary
Medications are categorized into generic, preferred brand-name, non-preferred brand-name, and excluded drugs, with generics and specialty biosimilars being the most cost-effective option. Use the Price a Drug tool on Caremark.com or the CVS Health mobile app (under Benefits > Drug Pricing) to see how your medication is covered in real time.
EUTF
The EUTF actives and non-Medicare retirees share the same non-specialty formulary, the Basic Control Formulary, and specialty formulary, the Advanced Control Specialty Formulary. The exclusion list below takes precedence over the formulary lists.
HSTA VB
The HSTA VB actives and non-Medicare retirees share the same non-specialty formulary, the Standard Opt Out Formulary, and do not have a separate specialty formulary. The exclusion list below takes precedence over the formulary list.
Pharmacy Network
Participating Pharmacy: The CVS Caremark Pharmacy Network features more than 200 pharmacies statewide and more than 68,000 pharmacies nationwide, including major retailers and local pharmacies. Find a participating pharmacy using our Pharmacy Locator.
Retail 90 Pharmacy: Save when filling a maintenance prescription at a Retail 90 pharmacy, where a member pays two times the 30-day copay for a 90-day supply. Retail 90 pharmacies include CVS, Costco, Safeway, Sam’s Club, Times, Walgreens, and Walmart pharmacies.
Mail Pharmacy: The CVS Caremark Mail Pharmacy on Oahu allows members to order maintenance medications with no shipping fees and delivery within 2-3 days, offering a cost advantage over some retail home delivery options. Copays are two times the 30-day copay, offering you the same low copays as at a Retail 90 pharmacy when ordering via mail. Disclaimer: If you have multiple insurance plans with drug coverage, there is no coordination of benefits through mail order. For more information, call CVS Caremark at 1-855-801-8263.
Specialty Pharmacy: For assistance with ordering specialty prescriptions or to locate a specialty pharmacy, call 1-855-801-8263. For assistance with ordering from CVS Specialty, call 1-800-896-1464. For coverage of non-preferred specialty medications, have your physician call 1-808-254-4414.
Non-Participating Pharmacy: Filling prescriptions at a non-participating or out-of-network pharmacy requires up-front payment of the full drug cost at the time of purchase, with reimbursement limited to the eligible charge less your out-of-network cost share. These out-of-pocket costs are not applicable to the calendar year maximum out-of-pocket. Claims must be submitted to CVS Caremark within one year from the date of purchase and can be submitted online through Caremark.com or the CVS Health mobile app (under Benefits > Claims). Paper claims can also be submitted via the Caremark paper claims form.
Utilization Management
The plan employs clinical guidelines including quantity limits, prior authorization, specialty guideline management, and generic step therapy to ensure safe, effective, and cost-efficient medication use.
- Quantity Limits: Ensure participants receive the medication in the quantity considered safe by the Food and Drug Administration (FDA), medical studies, and input, review, and approval from the CVS Caremark National Pharmacy and Therapeutics (P&T) Committee.
- Prior Authorization (PA): Clinical PA is a pre-approval process to ensure that certain therapy treatments or supplies are medically necessary before they are covered by the plan.
- Specialty Guideline Management (SGM): SGM uses evidence-based care plans and medication management outreach programs to help participants use these complex medications properly. All specialty medications require prior authorization. Physicians may call SGM at 1-808-254-4414 to obtain prior authorization.
- Generic Step Therapy Program (GSTP): Generic medications are an affordable and effective alternative to brand medications. For certain brand medications, GSTP requires that you try generic drug treatment(s) prior to the use of a brand drug.
- Dispensed as Written (DAW) Program: The DAW Program promotes the use of a generic equivalent medication, when available, in place of the associated brand-name medication. The standard generic copayment will apply. However, if a participant or their physician chooses to use a brand medication rather than the generic equivalent, then the copayment becomes the standard generic copayment plus the difference in cost of the generic and brand medication.
Questions?
Read the Frequently Asked Questions, go to the glossary page, or contact Customer Care toll-free at 1-855-801-8263 24 hours a day, seven days a week.
