CVS/SSI Retiree Benefits

What’s New?
Effective July 1, 2022 (unless otherwise specified):

  • Added prior authorization and quantity limit requirements for Opzelura (treats atopic dermatitis) and eye drops used to treat presbyopia (farsightedness), such as Vuity, under the EUTF non-Medicare retiree plan only.
  • Added prior authorization requirements for Kerendia (treats chronic kidney disease in adults with type 2 diabetes) under the EUTF non-Medicare retiree plan only. Existing members using Kerendia will be grandfathered and will not need to obtain prior authorization.
  • Added the CVS RxSavingsPlus program, which provides drug discounts for certain non-covered prescription drugs dispensed by participating network pharmacies, under the EUTF and HSTA VB non-Medicare retiree plans.
  • Excluded the Vision Enhancement Agents category from the EUTF non-Medicare retiree plan effective October 1, 2022, and from the EUTF Medicare retiree plan effective January 1, 2023. These are prescription ophthalmic products used to improve field of vision and includes Vuity (treats presbyopia or age-related blurry vision), Upneeq (treats droopy eyelids), and Acuvue Theravision with Ketotifen (corrects vision and treats eye allergies).
For EUTF Members
CVS/SSI PlanJanuary 1 - December 31, 2023January 1 - December 31, 2022
EUTF SSI Prescription Drug Plan (Medicare)Benefits at a Glance

Evidence of Coverage
Benefits at a Glance

Evidence of Coverage
EUTF CVS Prescription Drug Plan (Non-Medicare)Benefits at a GlanceBenefits at a Glance
For HSTA VB Members
CVS/SSI PlanJanuary 1 - December 31, 2023January 1 - December 31, 2022
HSTA VB SSI Prescription Drug Plan (Medicare)Benefits at a Glance

Evidence of Coverage
Benefits at a Glance

Evidence of Coverage
HSTA VB CVS Prescription Drug Plan (Non-Medicare)Benefits at a GlanceBenefits at a Glance