Prescription Drug Plan

You don’t need to come to the pharmacy to pick up your medicine. With our mail-order program, you can have it mailed to you. To sign up for the mail-order program:

• Submit your prescription to Carilion Clinic Pharmacy Crystal Spring.
• Submit a mail order form – list your current prescriptions as well as the current pharmacy location and phone number.
• Be sure to allow 10-14 days for the standard mail-order delivery. This allows us time to dispense and package your prescription as well as contact the physician or insurance if necessary. There is no charge for standard shipping and an overnight option for an additional charge.
• For more information, visit the Carilion Clinic Retail Pharmacy webpage.

If you take a maintenance medication, you need to use Carilion Clinic Pharmacy’s 90-day program to have your medication paid by our prescription drug plan.

• Maintenance medications are prescriptions you take regularly to treat an ongoing condition.
• If you use Carilion’s medical insurance, you can fill your maintenance prescriptions up to two times (for example, a first fill and a refill, or two refills) at a non-Carilion pharmacy. After that, you need to get your refills through Carilion Clinic Pharmacy’s 90-day program or you will be responsible for the full cost of the drug.

You can continue to have drugs that are not taken on a daily, ongoing basis filled at other pharmacies. An example is an antibiotic that you need to take for a short period of time. Some medications that have stricter regulations, such as Schedule II medications, also do not need to be filled through Carilion Clinic Pharmacy.

• Ask your doctor to write a prescription for a 90-day supply
• Submit your prescription to the Carilion Clinic Pharmacy of your choice. 
  • Pick up your medicine at the Carilion Clinic Pharmacy of your choice, or have it mailed to you.
  • Please allow three days’ notice for pick up of 90-day refills so the pharmacy can ensure the medication is in stock and available. Be sure to allow 10-14 days for standard mail-order delivery options.

Visit the Carilion Clinic Pharmacy website for more information about pick-up and delivery options.

• Save on your copays. The 90-day program gives you three months’ worth of medicine for less than or equal to the price of two and a half months.
• Fewer trips to the pharmacy. Instead of 12 trips to the pharmacy, get your medications four times a year.
• If you use mail-order delivery, free standard shipping and an overnight option for an additional charge. You’ll receive your standard orders in 10-14 days. If you need your medication sooner, ask about our overnight shipping option. 
• Online ordering for refills, order tracking and more. Visit our website for more information. 

We have a three-tier prescription program.

• Tier 1 (generic) drugs are the least expensive option.
• Tier 2 includes Aetna's preferred brand-name drugs. To find out if a drug is included, visit www.aetna.com/formulary. 
  • In the drop down menu choose plan year, then choose Aetna Standard Plans, click continue.
• Tier 3 drugs are brand-name medications that are not on Aetna's preferred-drug list. These prescriptions are the most expensive.
• Specialty medications can only be filled the Carilion Clinic Pharmacy Tanglewood location. The copay for specialty medications is $100 for a 30-day supply.
• You can access Aetna's Price-a-Drug tool through the Aetna Navigator website to help you determine your cost for your prescription.
• If you request a brand name drug when a generic is available, you will pay the generic copay plus the difference in the allowable charge between the brand name and the generic drug. This cost difference may cause the actual cost of the medication to be greater than the copays and maximums shown in the chart below.

For a 90-day supply at Carilion Clinic Pharmacy:

• Tier 1 (generic) medications: $22.50
• Tier 2 (preferred brand) medications: $87.50
• Tier 3 (non-preferred brand) medications: $125.00

For prescriptions that are not maintenance medications and have a 30-day supply or less:

• Tier 1 (generic) medications:
  • At Carilion Clinic Pharmacy: $9
  • At other pharmacies: $10
• Tier 2 (preferred brand) medications:
  • At Carilion Clinic Pharmacy: $35
  • At other pharmacies: $40
• Tier 3 (non-preferred brand) medications:
  • At Carilion Clinic Pharmacy: $50
  • At other pharmacies: $60
• Specialty Medications:
  • At Carilion Clinic  Specialty Pharmacy: $100
  • Located at Tanglewood on Electric Road, Roanoke VA. 

What is step therapy and how does it work?

• Aetna Pharmacy Member Services: 855-786-6879
• Aetna Navigator website: www.AetnaNavigator.com
• Community Pharmacy at CNRV: 540-639-1647 or fax to 540-639-0151 or submit refills through www.refillpro.com
• Medical Center Pharmacy in Roanoke: 540-853-0905 or fax to 540-853-0910
• CRMH Lobby Pharmacy: 540-266-6480 or fax to 540-266-6478 (Open 24 hours/day)
• 3 Riverside Pharmacy: 855-479-6245 or submit refills through www.refillpro.com
• Carilion Clinic Specialty Pharmacy: 540-772-8700

• Mail Order Prescriptions: 540-853-0905

   

• Mail Order and Specialty Pharmacy Services Patient Profile Form
• Visit the Carilion Clinic Retail Pharmacy page for more information.