Usually, yes. CVS Caremark, Express Scripts and OptumRx are pharmacy benefit managers (PBMs), not pharmacies. Most of their plans include independent pharmacies like Mega Health Rx in their networks. Some employer plans add rules for certain drugs, so it is worth a one-minute check.
What a PBM is
A pharmacy benefit manager runs the prescription part of your health insurance. It decides which drugs are covered (the formulary), what you pay, and which pharmacies are in network. The three largest are CVS Caremark, Express Scripts (owned by Cigna) and OptumRx (owned by UnitedHealth Group).
Having a Caremark card does not mean you have to fill at a CVS store, just as an Express Scripts card doesn’t tie you to one pharmacy.
Rules that sometimes apply
- Maintenance medication rules. Some employer plans allow only a few fills of a long-term medication at a retail pharmacy before requiring mail order or a 90-day supply at specific pharmacies.
- Specialty drugs. High-cost specialty medications may have to go through the PBM’s specialty pharmacy.
- Preferred networks. Some plans have lower copays at preferred pharmacies.
These rules vary by employer and plan. Your card does not tell you which apply — but we can check in about a minute.
How to check your plan
- Call us at (516) 304-5038 with your card.
- We run a test claim and tell you whether you are covered and what your copay will be.
- If there is a mail-order or specialty requirement, we explain your options and whether an opt-out is available.
Switching to us
If your plan covers you here, transferring takes about a minute. We call your current pharmacy and your doctor for you. See also transferring from CVS.
Frequently asked questions
Can I use CVS Caremark at an independent pharmacy?
Usually. Many Caremark plans include independent pharmacies in their network. Some employer plans restrict where certain drugs can be filled, so call us to check.
Does Mega Health Rx accept Express Scripts and OptumRx?
We accept most plans, including Express Scripts and OptumRx. Call us with your card to confirm.
Does my plan require mail order?
Some employer plans require mail order or specific pharmacies after a few fills of maintenance medications. We can check your plan and explain options.
Switch in about a minute
Tell us where you fill now and we handle every call. Free delivery anywhere in NYC, or pick up at 64-51 108th Street.