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OHR Home 2016 Caremark Rx Plan Selection Estimator
for Active Employees
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This worksheet is designed to assist you in determining which prescription plan (Standard Option or High Option) is best for the needs of you and your family. It will compute your projected overall out-of-pocket expenses for copays, deductibles and premium costs and compare them under the two plans. The worksheet will not calculate any penalties related to filling brand drugs with generic equivalents or maintenance medications at a non-CVS retail pharmacy.

Instructions:
A.  Specify your bargaining unit :
B.  Choose your coverage :
C.  Enter your estimated annual number of copays below. Remember, if you submit a 90-day prescription with 3 refills through the Maintenance Choice Program (either at a CVS/pharmacy retail location or through mail service), you pay only one copay for a 90-day supply, so be sure to take this into account. For example, you would enter "4" copays (not 12) in the generic drug type row if you take one generic maintenance medication (4 copays x 90 days = 360 day supply). Or, if you take two brand preferred maintenance medications, you would enter "8" copays (not 24) in the brand preferred row (2 drugs x 4 copays x 90 days = 360 day supply for each of the two drugs).
D.  Click the Calculate button.
Drug Type Estimated
Annual Copays
Standard
Option
High
Option
Copay * 1. Generic $00 $00
2. Brand Preferred with No Generic Available $00 $00
3. Brand Non-Preferred with No Generic Available  $00 $00
4. Brand with Generic Available $00 $00
Total Copay $00 $00
Annual Deductible $00 $0
Annual Premium $523 $2,755
Total Cost (Total Copay + Annual Deductible + Annual Premium)  $523 $2,755
Estimated Annual Savings when Choosing Standard Option: -$2,232
* The actual copay is the actual prescription cost or the listed copay, whichever is less.

If you are current participant, you can contact Caremark at (866) 240-4926 or visit www.caremark.com for your annual number of prescription fills, which may help you estimate your projected usage.

This tool helps you estimate which Caremark prescription plan would cost you less overall (Standard Option or High Option). Please note that you cannot elect or change plans through the use of this tool. This estimator applies to active, eligible employees of the County. It does not apply to employees who are temporary or retired. It also does not apply to employees of participating agencies.