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You can always access the most up-to-date information on your prescription benefits at info.caremark.com/stateoftn . Once you�ve registered, you can:
View your plan�s preferred drug list
Check drug costs
Print extra Prescription Cards Request new prescriptions using FastStartH Refill prescriptions
Sign up for ReadyFill at MailF (automatic prescription refill
program)
Find prescription savings tips
Print a claim form
File a paper claim (must be filed within 13 months of the service date or it will be denied)
Be sure to have your Prescription Card with ID number with you when you register.
For information about Plan Member Rights and Responsibilities, visit
Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information.
7529-IDX-1014
·
·
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·
·
·
·
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·
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Find more information online
What you�ll find inside:
The CVS/caremark Commitment to Plan Participants
Making the Most of Your Prescription Benefit Program
Your Prescription Benefit Plan
Getting Your Prescription Filled
Helpful Tips
The CVS/caremark Difference
Advantages of Generics
Common Brand with Generics Available
CVS Caremark Specialty Network for Chronic or Genetic Conditions
State of Tennessee Drug List
Mail Service Order Form
*0000111*
*0000111*
·
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any participating retail pharmacy.
For more information, visit
info.caremark.com/stateoftn or call a Customer Care
representative toll-free at 1-877-522-TNRX (8679).
Pharmacy Help Desk for Pharmacists: 1-800-364-6331
7529-ID50-0815
Submit paper claims to:
CVS/caremark Claims Department
P.O. Box 52136, Phoenix, AZ 85072-2136
Present this Prescription Card to / ll your prescription at
any participating retail pharmacy.
For more information, visit
info.caremark.com/stateoftn or call a Customer Care
representative toll-free at 1-877-522-TNRX (8679).
Pharmacy Help Desk for Pharmacists: 1-800-364-6331
7529-ID50-0815
Submit paper claims to:
CVS/caremark Claims Department
P.O. Box 52136, Phoenix, AZ 85072-2136
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DepFirstname1 DepLastname1
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IDNAME
RxBIN 004336RxPCN ADVRxGRP RX7529Issuer (80840) 9151014609
00001
1 of 4
00001
00001
{Begin_Tag}{EPSIIA_Tag}C_
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representative toll-free at 1-877-522-TNRX (8679).
Pharmacy Help Desk for Pharmacists: 1-800-364-6331
7529-ID50-0815
Submit paper claims to:
CVS/caremark Claims Department
P.O. Box 52136, Phoenix, AZ 85072-2136
Present this Prescription Card to , ll your prescription at
any participating retail pharmacy.
For more information, visit
info.caremark.com/stateoftn or call a Customer Care
representative toll-free at 1-877-522-TNRX (8679).
Pharmacy Help Desk for Pharmacists: 1-800-364-6331
7529-ID50-0815
Submit paper claims to:
CVS/caremark Claims Department
P.O. Box 52136, Phoenix, AZ 85072-2136
{Begin_Tag}{EPSIIA_Tag}C_
123456789
DepFirstname2 DepLastname2
123456789
DepFirstname3 DepLastname3
IDNAME
RxBIN 004336RxPCN ADVRxGRP RX7529Issuer (80840) 9151014609
IDNAME
RxBIN 004336RxPCN ADVRxGRP RX7529Issuer (80840) 9151014609
00002
2 of 4
00002
00002
{Begin_Tag}{EPSIIA_Tag}C_
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l Ass
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b s
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. htt
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ph
ao
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**S
av
ing
s a
re b
ase
d o
n p
lan
pa
rtic
ipa
nt
cop
ay
me
nts
. Th
e a
mo
un
t o
f y
ou
r sa
vin
gs
will
be
ba
sed
on
yo
ur
be
ne
, t
pla
n.
Glo
ba
l-B
CC
-Sta
nd
ard
-05
14
You
r P
resc
rip
tion
Car
ds
Present this Prescription Card to , ll your prescription at
any participating retail pharmacy.
For more information, visit
info.caremark.com/stateoftn or call a Customer Care
representative toll-free at 1-877-522-TNRX (8679).
Pharmacy Help Desk for Pharmacists: 1-800-364-6331
7529-ID50-0815
Submit paper claims to:
CVS/caremark Claims Department
P.O. Box 52136, Phoenix, AZ 85072-2136
Present this Prescription Card to , ll your prescription at
any participating retail pharmacy.
For more information, visit
info.caremark.com/stateoftn or call a Customer Care
representative toll-free at 1-877-522-TNRX (8679).
Pharmacy Help Desk for Pharmacists: 1-800-364-6331
7529-ID50-0815
Submit paper claims to:
CVS/caremark Claims Department
P.O. Box 52136, Phoenix, AZ 85072-2136
{Begin_Tag}{EPSIIA_Tag}C_
123456789
DepFirstname4 DepLastname4
123456789
DepFirstname5 DepLastname5
IDNAME
RxBIN 004336RxPCN ADVRxGRP RX7529Issuer (80840) 9151014609
IDNAME
RxBIN 004336RxPCN ADVRxGRP RX7529Issuer (80840) 9151014609
00003
3 of 4
00003
00003
{Begin_Tag}{EPSIIA_Tag}C_
1604123
{Begin_Tag}
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ma
rk. A
ll righ
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Glo
ba
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Sta
nd
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-05
14
Yo
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riva
cy
is imp
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nt to
us. O
ur e
mp
loy
ee
s are
tra
ine
d re
ga
rdin
g th
e a
pp
rop
riate
wa
y to
ha
nd
le
yo
ur p
riva
te h
ea
lth in
form
atio
n.
*Im
po
rtan
t Me
ssag
e o
n B
ack
Th
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on
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ca
rd is
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for
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ore
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Kn
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rics
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rip
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sk y
ou
r d
oct
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ph
arm
aci
st if
th
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is a
ge
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*So
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e: G
en
eri
c P
ha
rma
ceu
tica
l Ass
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ati
on
We
b s
ite
. htt
p:/
/ww
w.g
ph
ao
nlin
e.o
rg
**S
av
ing
s a
re b
ase
d o
n p
lan
pa
rtic
ipa
nt
cop
ay
me
nts
. Th
e a
mo
un
t o
f y
ou
r sa
vin
gs
will
be
ba
sed
on
yo
ur
be
ne
, t
pla
n.
Glo
ba
l-B
CC
-Sta
nd
ard
-05
14
You
r P
resc
rip
tion
Car
ds
Present this Prescription Card to , ll your prescription at
any participating retail pharmacy.
For more information, visit
info.caremark.com/stateoftn or call a Customer Care
representative toll-free at 1-877-522-TNRX (8679).
Pharmacy Help Desk for Pharmacists: 1-800-364-6331
7529-ID50-0815
Submit paper claims to:
CVS/caremark Claims Department
P.O. Box 52136, Phoenix, AZ 85072-2136
{Begin_Tag}{EPSIIA_Tag}C_
123456789
DepFirstname6 DepLastname6
IDNAME
RxBIN 004336RxPCN ADVRxGRP RX7529Issuer (80840) 9151014609
00004
4 of 4
00004
This Card
Intentionally
Left Blank.
Please Discard.
{Begin_Tag}{EPSIIA_Tag}C_
1604123
This Card
Intentionally
Left Blank.
Please Discard.
{Begin_Tag}
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