List of Covered Drugs (Drug Formulary)
All drugs covered through HSCSN are on the Drug Formulary. The formulary is another name for a list of prescription drugs. We update the list once every quarter. To get a copy of the Drug Formulary, call HSCSN Customer Care at (202) 467-2737 or 1 (866) 937-4549.
Medication Therapy Management (MTM)
Download the Pharmacy Benefits Services the Medication Therapy Management (MTM) Form.
Find a medication or pharmacy
Your HSCSN pharmacy benefits are through CVS Health. To learn how to find a medication and a pharmacy, call:
- CVS Customer Care Team - (866) 885-4944
- HSCSN Customer Care - (202) 467-2737 or 1 (866) 937-4549
Also, check the list of frequently asked questions below.
You have access to any local or national pharmacies in the United States enrolled in the CVS Health Pharmacy Network. If you wish to find out if your pharmacy is a part of the CVS Health Pharmacy Network, please call CVS Customer Care at (866) 885-4944.
Retail chains include:
- CVS Pharmacy
- Rite Aid
- Harris Teeter
DC Pharmacies in the CVS Network
Download the list of all in-network pharmacies [PDF]. HSCSN updates this list regularly.
To Get a Prescription Filled
If you have an HSCSN Enrollee ID card:
- Pick a pharmacy in the CVS Health network and close to home or work.
- Take your HSCSN ID Card with you to the pharmacy. The pharmacy will contact HSCSN for other information needed to fill your prescription.
- Do not pay for any medications.
- If the pharmacy asks you to pay or if you have other questions, call HSCSN Customer Care at (202) 467-2737 or 1 (866) 937-4549.
If you do not have an HSCSN ID card:
- Tell the pharmacy to call HSCSN Customer Care at (202) 467-2737 or 1 (866) 937-4549. They will look up your HSCSN ID number and give it to the pharmacy.
To get a prescription filled:
Pick a pharmacy that is part of the HSCSN network and is close to your work or home. When you have a prescription, go to the pharmacy, and give the pharmacist your prescription and your HSCSN Enrollee ID Card. If you need help, please call Customer Care Services at (202) 467-2737, 1 (866) 937-4549, or TTY/TTD (202) 467-2709.
Things to remember:
You should not be asked to pay for your medicines. Call HSCSN Customer Care Services if the pharmacy or drug store asks you to pay. y Sometimes, your doctor may need to get prior authorization (PA) from HSCSN for a drug. While your doctor is waiting for the prior authorization, you have a right to get the medication:
- For up to 72 hours or
- For one full round of the medicine if you take it less than once a day
If you need help or have questions:
- Call CVS Customer Care at (866) 885-4944.
CVS Caremark Mail Order Service
Enrollees now have the ability to obtain a 90 day supply of medication. If you wish to switch to Mail Order:
- Call CVS Customer Care at (866) 885-4944.
- Have your provider call CVS Customer Care at (866) 885-4944 or complete the Mail Order form below and fax it to 1-800-378-0323.
Download the Mail Service Fax Form
In some cases, CVS Health will need to approve the use of medications based on medical reasons. This is called a prior authorization (PA). To submit a PA request, have your doctor complete the PA form below and fax it to CVS Health at 1-888-836-0730. Your doctor can also call CVS Utilization Management Department at (877) 433-7643.
While you wait for PA approval, your pharmacist may provide your medication:
- For up to 7 days or
- For one full round of the medication if you take it less than once a day
If you are currently taking a medication that is not on the Preferred Drug List, your doctor can request an exception by faxing the exception request form below to CVS Health at 1-888-836-0730. If your doctor has any questions about the PA form, call 1-800-294-5979. Your doctor can also call CVS Utilization Management Department at (877) 433-7643.
Frequently Asked Questions
Q: What should I ask my pharmacist?
A: Here are things you should ask:
- What is my medicine used for?
- What should my doctor know before I take my medicine?
- How do I take my medicine(s)?
- What if I miss a dose of my medicine?
- Will other medicines or foods affect this medicine?
- Why does my medicine look different than it did before?
- Is my medicine a generic?
Q: How do I get a medication that requires Prior Authorization (PA)?
A: Talk to your doctor. They must request PA for the drug.
Q: What is a generic drug?
A: A generic drug is the same as a brand-name drug in:
- dosage, strength, safety, quality
- the way it works
- the way it is taken
- the way it should be used.
Q: Are generic drugs as strong as brand name drugs?
A: Yes. The government requires generic drugs to be equal to brand name drugs. That means they have the same quality, strength, purity, and stability.
Q: Why would my doctor choose a generic over a brand name?
A: Generic drugs are as safe and effective as a brand name. They usually cost much less than brand name drugs.
We Want to Hear From You
Enrolles - If you have any questions about your pharmacy benefits or the formulary contact:
- CVS Customer Care at (866) 885-4944
- HSCSN Customer Care at (202) 467-4737 or 1 (866) 937-4549.