MMC Benefits Handbook
Prescription Drug Programs
Rx Savings Solutions
Rx Savings Solutions is a program and tool to identify cost savings opportunities for prescriptions. Rx Savings Solutions sends proactive, personalized recommendations when an opportunity to save money on a prescription medication is identified. This means that if a lower cost alternative exists for a medication you may be taking (e.g. same medication in a slightly different dose, or a different medication that may work similarly to the one prescribed), Rx Savings Solutions will alert you that another medication option is available. This benefit is available to all members who participate in the Surest Copay Plan and CVS Caremark® prescription drug plan at no cost to you.
When you receive a recommendation from Rx Savings Solutions, you have the option to talk to your prescriber about changing your prescription, have Rx Savings Solutions assist you by using the Contact Prescriber feature described below, or stay with your initial prescription.
Rx Savings Solutions will send personalized notifications by email (or text message, if you enroll in this service) whenever savings opportunities are found. You may also view savings opportunities from a personal dashboard through the Rx Savings Solutions member portal at https://mmc.rxsavingssolutions.com, as well as those for enrolled family members.
Rx Savings Solutions also offers the following features:
- Medicine Cabinet - a list of medicines a member is taking
- Medication Reminders - reminders for members to take their medication to promote adherence
- Contact Prescriber – members can use the "Contact Prescriber" option to have Rx Savings Solutions call the member's prescriber to assist the member in getting a new prescription. It automates the process of changing prescriptions when a member decides to take advantage of a savings opportunity (participation is optional).
Call Rx Savings Solutions at +1 800 268 4476, Monday to Friday, 8:00 am to 9:00 pm Eastern Time or visit https://mmc.rxsavingssolutions.com for more information.
PrudentRx Program
PrudentRx is a program that can help you receive, at no cost, eligible specialty medications for the treatment of complex chronic conditions, including, but not limited to, multiple sclerosis, cancer and rheumatoid arthritis.
You are eligible for the PrudentRx Program if you are currently taking a specialty medication covered under the prescription drug benefit that is on the PrudentRx Drug List (available at www.caremark.com), you receive your prescription drugs benefits through CVS Specialty Pharmacy, and you are enrolled in the Surest Copay Plan.
If you are eligible for the PrudentRx Program and your specialty medication is on the PrudentRx Drug List (available at www.caremark.com), you must participate and enroll in the PrudentRx Program to receive your specialty medication free of charge. If eligible, you'll be enrolled in the PrudentRx program. PrudentRx will reach out to you or your enrolled family members to gather information upon filling a prescription through CVS Specialty Pharmacy. PrudentRx will send a letter followed up by a phone call to provide specific information about the program and gather required information as it relates to your specialty medication, which will be filled through CVS Specialty Pharmacy. To secure your enrollment and participation in the PrudentRx program, you must speak with PrudentRx.
You can see the eligible specialty medications included in the PrudentRx Program, (i.e., on the PrudentRx Drug List) at www.caremark.com. The PrudentRx Drug List may be updated periodically.
These specialty medications are considered non-essential health benefits under the program and the cost of such medications will not be applied towards your out-of-pocket maximum as there will be no cost to you.
Participating in the PrudentRx program means that you must speak with PrudentRx to verify your enrollment and properly complete any steps required by a manufacturer to obtain copay assistance. If you do not speak with PrudentRx, you'll be responsible for paying the 30% coinsurance cost for each eligible specialty prescription medication, and the costs will NOT count towards either out-of-pocket maximum.
If your specialty medication is not on the PrudentRx drug list, your medication cost share follows 90-day supply copays outlined in "How does the Plan cover prescription drugs?." If you receive less than a 90-day supply, your copay is prorated based on the day supply of medication you receive.
If You're Currently Enrolled in a Manufacturer Copay Assistance Program:
If you're currently enrolled in a manufacturer copay assistance for a specialty medication and this medication is on the PrudentRx Drug list, you'll need to provide the manufacturer copay enrollment information to PrudentRx in order to pay $0 for this medication. If you do not speak with PrudentRx and provide the manufacturer copay enrollment information to PrudentRx, you'll be responsible for paying the 30% coinsurance cost for each eligible specialty prescription medication, and the costs will NOT count towards either out-of-pocket maximum.
If You're Not Currently Enrolled in a Manufacturer Copay Assistance Program:
If you're not currently enrolled in a manufacturer copay assistance for a medication on the PrudentRx Drug list and the manufacturer requires enrollment in copay assistance, you'll need to speak with PrudentRx so that PrudentRx can assist with getting you enrolled with the manufacturer copay assistance in order to pay $0 for this medication. PrudentRx will contact you if you're required to enroll in the copay assistance for any medication that you take. PrudentRx will work with you and the drug manufacturer to get copay assistance and will manage enrollment and renewals on your behalf. If you do not enroll in any copay assistance as required by the manufacturer, you'll be responsible for paying the 30% coinsurance cost for each eligible specialty prescription medication, and the costs will NOT count towards either out-of-pocket maximum.
If you do not speak with PrudentRx, do not enroll in any copay assistance as required by a manufacturer, or do not choose to participate in the PrudentRx program, i.e. opt out, you'll be responsible for paying the 30% coinsurance cost for each eligible specialty prescription medication, and the costs will NOT count towards either out-of-pocket maximum.
For additional information, refer to "Are there mandatory discount or copay assistance programs applicable for specialty prescription drugs?."
You may contact PrudentRx directly if you missed their outreach or have any questions regarding the PrudentRx program. Specially trained customer care advocates are available at +1 800 578 4403, Monday through Friday, from 9:00 am to 9:30 pm and Saturday, 9:00 am to 6:00 pm, Eastern Time.
Transform Diabetes® Care Program
Transform Diabetes Care offers care for you and your eligible family members age 18 years of age and older enrolled in the Surest Copay Plan who've been diagnosed with diabetes. This program is available at no cost to you and your eligible family members. If you're diagnosed with diabetes, you're automatically enrolled. All eligible members will receive communication in the mail with instructions on how to enroll and use the program.
As a part of this program, you and your eligible family members will receive individualized support across five clinical impact areas:
- Glucose and blood pressure monitoring including no cost diabetes test strips (if eligible based on your individual needs and a review from a trained diabetes educator).
- Lifestyle and comorbidity management
- Medication optimization
- Preventative screenings
- Medication adherence
The program provides coaching support from a health coach and a Certified Diabetes Nurse.
Who is Eligible for the Transform Diabetes Care Program?
Members diagnosed with diabetes age 18 years of age and older who are enrolled in the Surest Copay Plan with prescription drug coverage through CVS Caremark®.
If you have any questions about eligibility, you may contact CVS Caremark® at +1 844 449 0362.
Hello Heart Program
Hello Heart provides care and support to you and your eligible family members age 18 years of age and older enrolled in the Surest Copay Plan who've been diagnosed with hypertension or are at risk of being diagnosed with hypertension. This program is available at no cost to you and your eligible family members. All eligible members will receive communication in the mail with instructions on how to enroll and use the program.
The program provides digital remote blood pressure monitoring. As part of Hello Heart program, you will receive the following:
- Access to the Hello Heart mobile application that includes digital coaching and support aimed at improving heart health
- Hello Heart blood pressure monitor.
If you qualify, you'll receive a blood pressure monitor. You'll have the ability to register for the program via Hello Heart's online portal and download the Hello Heart application to your mobile device, for access to additional tracking tools and resources for heart health.
Who is Eligible for the Hello Heart Program?
Members diagnosed with hypertension or are at risk of being diagnosed with hypertension who are 18 years of age and older and enrolled in the Surest Copay Plan with prescription drug coverage through CVS Caremark®.
If you have any questions about eligibility, you may contact CVS Caremark® at +1 844 449 0362 or Hello Heart at +1 800 767 3471.
WW Digital Program
The WW Digital Program provides science-based tools to help you and your eligible family members 18 years of age or older enrolled in the Surest Copay Plan lose weight, eat healthier, move more, and develop a more positive mindset. The program is available at no cost to you and your eligible family members.
WW Digital includes:
Who is Eligible for the WW Digital Program?
Members who are 18 years of age and older and enrolled in the Surest Copay Plan with prescription drug coverage through CVS Caremark®.
If you have any questions about the program, you may contact CVS Caremark® at +1 844 449 0362 or WW Customer Care at +1 866 204 2885. To learn more or enroll, visit WW.com/MarshMcLennan.