Citi Benefits Handbook
Specialty Medication Copayment Assistance
Specialty medications may qualify for third-party copayment assistance programs that could lower your out-of-pocket costs for those products. In many of these programs, your copay/coinsurance may be reduced for a 31-day supply of your specialty medication. Please note that any assistance received will not count towards your annual deductible or total out-of-pocket maximum you are required to pay related to Plan coverage.
CVS Specialty® will help you to receive third-party copayment assistance for these particular prescribed drugs. If obtained, any reduction in your copay/coinsurance amount will not be applied toward your annual deductible or total out-of-pocket cost related to Plan coverage. Enrollment in the program is voluntary. If you choose not to participate in the copayment assistance programs, you will be required to pay the full prescription drug copay/coinsurance amount.
Eligibility for third-party copay assistance programs is dependent on the applicable terms and conditions of a particular program. The terms and conditions of such programs are subject to change. This program is offered as part of your Plan's exclusive specialty pharmacy network with CVS Specialty. Please note that the list of specialty drugs eligible for specialty copayment assistance programs is subject to change.
- To enroll, call CVS Caremark Customer Care at 1 (844) 214-6601. The CVS Specialty Care Team will coordinate the filling of your specialty medication prescription and enroll you in the available manufacturer's copay assistance program. Once enrolled in the program, your medication will continue to be filled through CVS Specialty Pharmacy, your specialty mail service provider.
- Additionally, the designated pharmacy will enter the copay assistance details when submitting the initial and subsequent claims and the copay assistance benefit will be applied by CVS Specialty to all related prescriptions.
- You may continue to use copay cards to help reduce your copay/coinsurance. However, any resultant reduction in your copay/coinsurance amount from the use of the card will not apply towards your annual deductible or out-of-pocket maximum that you are required to pay related to plan coverage.