Prescription Benefits

Your prescription drug coverage is administered by CVS Caremark and is included automatically when you enroll in the Aetna Consumer-Directed Health Plan (CDHP) or the Aetna Managed Choice POS. You must be enrolled in a Starr Aetna medical plan to have CVS Caremark coverage. To learn more, visit CVS Caremark.

Employees enrolled in the Kaiser HMO — available to employees in Los Angeles and San Francisco, California, and to employees throughout Georgia, subject to ZIP code — receive prescription drug coverage through Kaiser, not CVS Caremark. See Medical for Kaiser pharmacy copays. 

Fill at a network pharmacy.

You pay the lowest cost when you use a pharmacy in the CVS Caremark network. Use the Pharmacy Locator tool at Caremark.com to find one near you.

Under the CDHP, prescriptions share one deductible with your medical care.

Your $2,000 individual or $4,000 family deductible covers medical and prescription claims together. Until you meet it, you pay the full cost of your prescriptions — other than preventive medications, which are always $0. Your out-of-pocket maximum is combined the same way.

Preventive medications are covered at 100%.

Qualifying preventive drugs are covered at a $0 copay on both plans, with the deductible waived, so there is no cost barrier to staying on the medications that keep a condition controlled.

Check the price before you fill.

The Check Drug Cost tool compares what the same medication costs across in-network pharmacies, and shows covered alternatives such as a generic. Prices vary more than most people expect.

Long-term medications move to a 90-day supply after two fills.

If you take a medication on an ongoing basis, you are allowed two 30-day fills. After that, you move to a 90-day supply, which also costs less per dose.

Generics are the single biggest saver.

A generic has the same active ingredient, strength, and dosage as its brand-name equivalent, and must meet the same FDA standards. About 87% of all CVS Caremark prescriptions are filled with generics.

What you pay depends on which Aetna medical plan you choose, which tier your medication falls into, and whether you fill a 30-day or a 90-day supply.

Under the CDHP, prescription and medical claims share a single deductible, and you pay the full cost of a prescription until that deductible is met. Under the Managed Choice POS, prescription copays apply with no deductible.

Prescription costs are one of the few health care expenses you can predict, which makes them one of the easiest to plan around. Two things determine what you spend: the account you use to pay, and the choices you make before you fill.

Pay with pre-tax money

If you are enrolled in the CDHP, use your Health Savings Account (HSA). Starr contributes up to $500 if you have employee-only coverage or up to $1,000 if you cover dependents, based on your participation in the plan for the full year (24 pay periods). Keep in mind that you can only spend money already deposited in your account — the balance builds with each paycheck rather than arriving all at once in January.

If you are enrolled in the Managed Choice POS or the Kaiser HMO, use your Health Care Flexible Spending Account (HCFSA). Your full annual election is available on the first day of the plan year, but unused money does not roll over — estimate carefully, because you must use it or lose it. The 2026 Health Care FSA limit is $3,400.

Four ways to lower what you pay

Ask whether a generic is right for you. A generic contains the same active ingredient as its brand-name equivalent and meets the same FDA standards. That is a $20 copay instead of $60 or $80 for a 30-day supply.

Ask whether an over-the-counter version would work. Several medications that once required a prescription — many allergy treatments among them — are now available over the counter, sometimes for less than the copay.

Switch long-term medications to a 90-day supply. A 90-day generic supply costs $50, compared with $60 for three 30-day fills — and after two 30-day fills of a long-term medication, you move to a 90-day supply anyway.

Compare pharmacies before you fill. The Check Drug Cost tool at Caremark.com shows what the same medication costs across in-network pharmacies.

If you take a medication regularly — for blood pressure, cholesterol, asthma, diabetes, or a similar ongoing condition — your plan limits you to two 30-day fills. After that, you move to a 90-day supply.

It also saves you money. A 90-day supply costs $50 generic, $150 preferred brand, or $200 non-preferred brand — less than filling the same medication three times at the 30-day rate. Under the CDHP these amounts apply once you have met your combined deductible; under the Managed Choice POS there is no deductible.

To learn more, visit CVS Caremark.

How to get started

Register or sign in at Caremark.com/StartNow, then select the prescription you want to move to a 90-day supply. Or ask your doctor to write your next prescription for a 90-day supply and send it to the pharmacy you prefer.

Specialty medications treat complex or chronic conditions such as rheumatoid arthritis, multiple sclerosis, psoriasis, and certain cancers. They often require special handling, close clinical monitoring, or injection or infusion. Under both Aetna plans, specialty medications carry a $120 specialty copay. That copay does not apply to drugs on the PrudentRx list.