Citi Benefits Handbook
Prior Authorization with CVS Caremark
For you to purchase certain medications or to receive more than an allowable quantity of some medications, your pharmacist must receive prior authorization from CVS Caremark before these drugs will be covered under the Citigroup Prescription Drug Program.
- Examples of medications requiring prior authorization are Retin-A cream, growth hormones, anti-obesity medications, rheumatoid arthritis medications and Botox.
- Examples of medications whose quantity will be limited are smoking cessation products, migraine medications and erectile dysfunction medications.
Other medications, such as certain non-steroidal anti-inflammatories, will be covered only in situations where a lower-cost alternative medication is not appropriate.
To determine whether your medication requires prior authorization or is subject to a quantity limit, call CVS Caremark at 1 (844) 214-6601 or visit the CVS Caremark website at www.caremark.com. Your pharmacist can also determine whether a prior authorization is required or a quantity limit will be exceeded at the time your prescription is dispensed.
If a review is required, you or your pharmacist can ask your physician to initiate a review by calling 1 (844) 214-6601. After your physician provides the required information, CVS Caremark will review your case, which typically takes one to two business days. Once the review is completed, CVS Caremark will notify you and your physician of its decision.
If your medication or the requested quantity is not approved for coverage under the Citigroup Prescription Drug Program, you can purchase the drug at its full cost to you.
Medication Review with CVS Caremark
Under certain circumstances, you and your physician may request that CVS Caremark perform a medical review of your medications. For additional information and instructions on how your physician can request a review, call CVS Caremark at 1 (844) 214-6601.