PrudentRx has collaborated with CVS Caremark® to offer a copay assistance program that will help save you money when you fill your specialty medication prescription through CVS Specialty®.

What are Specialty Medications?:
Through the Aetna health plan, your specialty medications are dispensed through CVS Specialty Pharmacy.  There are over 400 Specialty medications available today and that number is rapidly growing. Rare diseases requiring specialty medication affect between 25-30 million patients.  Specialty medications provide added relief for patients with Hepatitis C, Autoimmune disorders, Oncology and Multiple Sclerosis. 

Specialty medications typically cost several hundred dollars monthly, as they may require unique methods of administration such as injections, infusions, or nebulizers. In addition, routine patient monitoring may require lab tests, office visits, enrollment and documentation into monitoring programs, medication risk evaluation and prior authorization from the insurer (Aetna).

How does it work?:
PrudentRx will work with you to obtain third-party copay assistance for your medication, if available.  Once you’re enrolled, you’ll pay nothing out-of-pocket – that’s right, $0! – for medications on your plan’s specialty drug list dispensed by CVS Specialty.  Even if your covered specialty medication under the PrudentRX drug list has no copay card, your out-of-pocket costs will be $0, as long as you are enrolled in the PrudentRx program. Some exclusions do apply. Any specialty prescriptions not eligible under PrudentRx will fall to the applicable tier for that drug.

How do I get started?:
If you start a new medication covered under the program, they will reach out to you. You can also contact them directly at 1-800-578-4403.

You can choose to opt-out at any time. Not all specialty prescriptions offer assistance.  PrudentRx will also contact you if you are required to enroll in the copay assistance for any medication that you take. If you do not return their call, choose to opt-out of the program, or if you do not affirmatively enroll in any copay assistance as required by a manufacturer, you will be responsible for 30 percent of the cost of your specialty medications.

Is my Specialty Medication Covered Under PrudentRx?:
As with any formulary, the Specialty Medication list will be updated periodically. However, even if your covered specialty medication under the PrudentRX drug list has no copay card, your out-of-pocket costs will be $0, as long as you are enrolled in the PrudentRx program.

Some exclusions do apply. Any specialty prescriptions not eligible under PrudentRx will fall to the applicable tier for that drug.

PrudentRX Drug List November 2023

Frequently Asked Member Questions:
Please view the Frequently Asked Question (FAQ) to answer many questions on the new Specialty Drug Program through PrudentRx.

Contact Information:
Call PrudentRx at 1-800-578-4403,
Monday through Friday, from 8 AM to 8 PM. ET.