Prescription Coverage

  • CVS/Caremark is the DCIU Prescription Provider

    The links below outline the current Formulary used by CVS/Caremark to determine covered prescriptions, the mail order form if you prefer to have your 90 day supply maintenance drugs sent directly to your home and the appeals process shoud you get denied coverage for a prescribed medication. 

     

    CVS Appeals Process for Delaware County Intermediate Unit

    The Delaware County Intermediate Unit (DCIU) offers prescription drug coverage to full time employees through CVS/Caremark. Similar to other medical plans, the prescription drug benefit plan has requirements, restrictions, limitations and exclusions. As a result, the DCIU has a formal appeal process that allows members to contact an independent party for appeal submission, review and determination. The independent party will ensure that the appeal determination is unbiased and based on clinical documentation. Please be advised that the Benefits Office cannot provide prescription overrides.

    The request for review must be submitted in writing and include supporting clinical document. The request may be faxed or mailed via the following.

    Standard Appeals

    • Fax: 1-866-443-1172; Attention: Appeals Department
    • Mail: CVS/Caremark, Inc. Appeals Department MC 109
      P.O. Box 52084 Phoenix, AZ 85072-2084

    Specialty Appeals

    • Fax: 1-855-230-5548; Attention: Appeals Department
    • Mail: CVS/Caremark Inc. Specialty Guideline Management Appeals Department
      800 Biermann Court Suite B Mt. Prospect, IL 60056