When you choose an ITW medical plan, you automatically get prescription drug coverage through CVS Caremark.
Prescription Drugs
Overview
You can go to a retail pharmacy for your short-term medication needs (such as antibiotics). You can fill long-term or maintenance medications (such as insulin or blood pressure medication) only twice at a retail pharmacy. After that, you’ll need to fill them using Maintenance Choice (in person at CVS retail pharmacies) or mail order (through CVS Caremark).
If you fill a brand-name drug when a less expensive generic alternative is available, you’ll pay the difference between the cost of the brand name and the generic plus your copayment or coinsurance. But if your doctor believes that a generic option isn’t right for you, he or she can submit medical documentation to CVS Caremark and request approval to use a brand-name drug. If the request is approved, you will not have to pay the additional cost.
All three plans will cover generic preventive medications at no cost. The chart below shows what you pay to fill other prescriptions.
What You Pay to Fill Prescriptions
| HealthSaver | PPO1 and PPO2 | |
|---|---|---|
| Retail (up to a 30-day supply) | ||
| Preventive Generic | No cost to you | No cost to you |
| Generic | 20% after the medical deductible | $20 copayment (or cost of prescription if less) |
| Preferred Brand | 20% after the medical deductible | 25% (up to $125) |
| Non-Preferred Brand | 20% after the medical deductible | 40% (up to $275) |
| Mail Order (up to a 90-day supply)/Maintenance Choice (90-day supply) | ||
| Preventive Generic | No cost to you | No cost to you |
| Generic | 20% after the medical deductible | $40 copayment (or cost of prescription if less) |
| Preferred Brand | 20% after the medical deductible | 25% (up to $300) |
| Non-Preferred Brand | 20% after the medical deductible | 40% (up to $600) |
| Specialty (up to a 30-day supply) | ||
| Generic or Brand | 20% after the medical deductible | $0 for eligible specialty medications when you are enrolled in the PrudentRx Copay Program or 30% if you are not enrolled in the PrudentRx Copay Program or the medication is not eligible for the program |
| Annual Prescription Drug Out-of-Pocket Maximum | ||
| Individual | Included in medical out-of-pocket maximum | $2,500 |
| Family | Included in medical out-of-pocket maximum | $5,000 |
Note: There is a lifetime maximum of $20,000 for fertility prescription medication.
PrudentRx Copay Program
Employees and their family members with specialty prescription drugs — generally high-cost medications used to treat complex, chronic or rare conditions — who are enrolled in the PPO1 or PPO2 medical plan can take advantage of the PrudentRx Copay Program and get their eligible specialty prescriptions for $0. PrudentRx will reach out to you if you are taking an eligible specialty medication to enroll you in the program. If you don’t join the program or your medication is not eligible, you’ll pay 30% of the cost for the same medication. Note: fertility prescription medications are not included in the PrudentRx Copay Program.
Ready to Enroll? Here’s How.
Make sure you have the benefits you want for 2025 to live life your way. Here’s how:
- Learn about benefit changes, choices and resources to help you prepare to enroll.
- When you’re ready to enroll, log on to ITWemployee.com. Click the Open Enrollment banner and follow the steps to review and enroll in 2025 benefits.
Call 1.866.489.2468, Option 1, Monday through Friday 7 a.m. to 7 p.m Central time, November 4-18.
Contacts
CVS Caremark CoPay Calculator
Get cost estimates, find generic alternatives.
HealthSaver Plan CoPay Calculator
(Before deductible)
HealthSaver Plan CoPay Calculator
(After deductible)
CVS Caremark
Get cost estimates, check on prescriptions, order refills.
Log on to ITWemployee.com, then click on the Prescriptions icon under the Benefit Provider Websites drop-down.