CVS Active Benefits

What’s New?
Effective July 1, 2023:

  1. Added the Tier 1 Strategy to the EUTF Active plans, which allows pharmacies to dispense a targeted brand product when the cost for the brand is less than the generic. Member pays the generic copay or the cost of the drug, whichever is less.
  2. Changed coverage for metformin (850mg) to a $0 copay under the EUTF and HSTA VB Active plans in accordance with federal law.
  3. Changed coverage for male condoms, when prescribed, to a $0 copay under the EUTF and HSTA VB Active plans in accordance with federal law.
  4. Excluded coverage of low-dose aspirin (81mg) for males ages 50 to 59 under the EUTF Active plans.
For EUTF Members
CVS PlanJuly 1, 2023 - June 30, 2024July 1, 2022 - June 30, 2023
EUTF CVS 90/10 PPO PlanSummary of Benefits and Coverage

Benefits at a Glance
Summary of Benefits and Coverage

Benefits at a Glance
EUTF CVS 80/20 PPO PlanSummary of Benefits and Coverage

Benefits at a Glance
Summary of Benefits and Coverage

Benefits at a Glance
EUTF CVS 75/25 PPO PlanSummary of Benefits and Coverage

Benefits at a Glance
Summary of Benefits and Coverage

Benefits at a Glance
EUTF CVS HMO PlanSummary of Benefits and Coverage

Benefits at a Glance
Summary of Benefits and Coverage

Benefits at a Glance
For HSTA VB Members
CVS PlanJuly 1, 2023 - June 30, 2024July 1, 2022 - June 30, 2023
HSTA VB CVS 90/10 PPO PlanSummary of Benefits and Coverage

Benefits at a Glance
Summary of Benefits and Coverage

Benefits at a Glance
HSTA VB CVS 80/20 PPO PlanSummary of Benefits and Coverage

Benefits at a Glance
Summary of Benefits and Coverage

Benefits at a Glance