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1-800-578-4403 Monday through Friday 8 a.m. to 8 p.m. EST (English and Spanish language available). Language. line available for other languages. What Happens If I Fail to Contact the . PrudentRx Member Advocate Team? If you do not contact the PrudentRx member advocate team, they will reach out to you via telephone. If you do Prior Authorization Dept: 1-800-294-5979 PrudentRx: 1-800-578-4403 www.caremark.com Specialty Pharmacy: www.cvsspecialty.com: Fidelity: Health Savings Account ... •Step Two: You need to call PrudentRx at 1-800-578-4403 within the next 5-days to register for any copay assistance. available from drug manufacturers. It is essential to complete step two and become fully enrolled to avoid being opted out of the program. 1-800-578-4403 Monday–Friday 8am to 8pm EST prudentrx.com PAGE2OF2 CVS Specialty Pharmacy may be reached at 1-866-387-2573 and PrudentRx at 1-800-578-4403. Advanced Utilization Management Program. These programs may require additional information from a prescribing physician in order for a prescription to be covered and paid for by the University’s health plan. Failure to provide additional information may ...

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choose to opt out of the program by calling 1-800-578-4403. Some manufacturers make you to sign up to take advantage of the copay assistance that they provide for their medications – in that case, you must speak to someone at PrudentRx at 1-800-578-4403 to provide any other information needed to enroll in the program.Program. PrudentRx can be reached at (800) 578-4403 to address any questions regarding the PrudentRx Co-Pay Program. CVS Maintenance Choice Voluntary: 90-day supply Generic Drug $30 Copay Formulary Drug $60 Copay Non-Formulary Drug $100 Copay Preventive Drug (Prescription Drugs classified as a Preventive Drug by HHS) $0 Copay …Faculty and staff who receive a letter should contact PrudentRx at 1-800-578-4403 to sign up for the program. If no contact is made PrudentRx will attempt to reach out by phone directly to the employee as well. Please email [email protected] if you any questions. As a reminder, faculty and staff utilizing specialty medications who enroll in the ...800-578-4403 PacificSource.com LRG726_0224 Get $0 specialty medications with PrudentRx PacificSource has collaborated with CVS Caremark ® and PrudentRx on a program that helps lower your out-of-pocket costs to $0 for eligible specialty medications by using manufacturer coupons. Specialty medications include drugs prescribed for some rare

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Please note: If you are a plan member, please call 1-800-578-4403 and a customer service advocate will be available to answer any questions and enroll you in the program. Representatives are available Monday through Friday from 8 a.m. to 8 p.m. ET. ACROMEGALY octreotide acetate (SANDOSTATIN) SANDOSTATIN LAR SOMATULINE DEPOT 1 SOMAVERT1

$800 ; Individual / $1,600 ; Family Per calendar year. Generally, you must pay all of the costs from providers up to the deductible ... PrudentRx may be reached at 1-800-578-4403. If you have outpatient surgery . Facility fee (e.g., ambulatory surgery center) 10% coinsurance after deductible : 30% coinsurance after deductible :Contact a PrudentRx Advocate at 1-800-578-4403 with any questions or assistance with enrolling in the program. Substance Abuse/Mental Health Support and Treatment.To enroll, contact PrudentRx at 1-800-578-4403. You pay 100%. Plan reimburses no more than it would have paid had you used an In-Network Retail pharmacy. Deductible does not apply. • Specialty drugs require preauthorization by calling CVS Specialty Pharmacy at 1-866-387-2573. For most specialty drugs, the contracted specialty drugFor many businesses, securing an 800 number is an important step in expanding their reach to customers across the nation. Because toll-free numbers place the cost of the call on th...PrudentRx program, but you may call 1-800-578-4403 to opt out once you receive your welcome letter. • Some manufacturers require you to sign up to take advantage of the copay assistance that they provide for their medications—in that case, you must speak to someone at PrudentRx at 1-800-578-4403 to provide any additional information neededPhone: 1-800-521-7387 Email: [email protected]. HR Shared Services team. Phone: 1-866-263-8411. Email: [email protected]. CVS Caremark, prescription drug coverage through national carriers Phone: 1-855-821-0355. Website: caremark.com. Transform Diabetes Care. Phone: 1-800-348-5238. PrudentRX. Phone: 1 …Anthem BlueCross BlueShield P.O. Box 105187 Atlanta, GA 30348-5187 Phone: +1 855 570 1150 Website: www.anthem.com. Group #: 270146. (Be sure to check your claim form or instructions for the address of the claims processing office.) Pharmacy Benefits Manager. CVS Caremark One CVS Drive.

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1-800-578-4403, Mondaythrough Friday 8 a.m. to 8 p.m. EST (English and Spanish language available). Languageline available for other languages. If you do not contact the PrudentRx Member Advocate team, they will reach out to you via telephone. If you do not answer or return the call, and enroll in any copay

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can be reached at 1-800-578-4403 to address any questions regarding the PrudentRx solution. Preferred brand drugs $30 copay / retail prescription $60 copay / mail-order prescription $30 copay plus remaining balance after pharmacy is paid at network rate Preferred multisource brand drugs $22 copay / retail prescription $44 copay / mail-order

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