Which Insurance Uses CVS Caremark? A Comprehensive Guide

In the ever-evolving landscape of healthcare, understanding how prescription drug benefits are managed can feel like navigating a maze. One key player in this system is CVS Caremark, a leading pharmacy benefit manager (PBM) in the United States. If you’re wondering, “Which insurance uses CVS Caremark?” you’re not alone. This question is crucial for anyone looking to understand their pharmacy benefits or evaluate insurance options. In this 2900-word article, we’ll dive deep into the world of PBMs, spotlight CVS Caremark’s role, and identify the insurance plans and companies that rely on its services. Optimized for search engines and packed with reliable information, this guide will also include links to source sites for further exploration.

What is a Pharmacy Benefit Manager (PBM)?

Before we answer which insurance uses CVS Caremark, let’s clarify what a PBM does. A pharmacy benefit manager is a third-party administrator that manages prescription drug programs for health insurance plans, employers, unions, and government programs. PBMs serve as intermediaries between insurers, pharmacies, and drug manufacturers, aiming to streamline the process and reduce costs. Their core responsibilities include:

Negotiating Discounts and Rebates: PBMs leverage their scale to secure lower drug prices from manufacturers, often through rebates tied to prescription volume.
Formulary Management: They decide which medications are covered under an insurance plan’s formulary, organizing them into tiers that determine patient copays.
Claims Processing: PBMs handle prescription claims, ensuring pharmacies are reimbursed and members pay the correct amount.
Pharmacy Network Management: They establish networks of pharmacies where members can fill prescriptions at negotiated rates.

By performing these functions, PBMs aim to make medications more affordable and accessible. However, their role has sparked debate, which we’ll explore later. For now, let’s focus on CVS Caremark, one of the industry’s giants.

What Pharmacies Does CVS Caremark Cover?

CVS Caremark: A PBM Powerhouse

CVS Caremark is a subsidiary of CVS Health, a healthcare conglomerate that also owns CVS Pharmacy and the insurance company Aetna. As one of the largest PBMs in the U.S., CVS Caremark processes billions of prescriptions annually and serves a diverse client base, including employers, insurance companies, unions, and government health plans. According to the Drug Channels Institute, CVS Caremark, alongside Express Scripts and Optum Rx, controls roughly 80% of the PBM market share, highlighting its dominance.

What sets CVS Caremark apart? Its integration within CVS Health allows it to offer a seamless ecosystem. Members can fill prescriptions at CVS Pharmacy locations, use mail-order services, or access digital tools like the CVS Caremark mobile app. This interconnectedness is particularly beneficial for insurance plans under the CVS Health umbrella, but its services extend far beyond that.

So, which insurance plans and companies tap into CVS Caremark’s expertise? Let’s break it down by category, with examples backed by credible sources.

Prescription Benefits Partnered with CVS Caremark: A Comprehensive Guide

Insurance Plans and Companies That Use CVS Caremark

CVS Caremark partners with a wide range of entities to manage prescription drug benefits. Below, we’ve categorized its clients and provided specific examples, ensuring you have a clear picture of its reach.

1. Aetna: A CVS Health Family Member

Since CVS Health acquired Aetna in 2018, it’s no surprise that Aetna relies on CVS Caremark as its PBM. This partnership is more than a contractual arrangement—it’s an integrated relationship. Aetna members benefit from synchronized medical and pharmacy services, such as filling prescriptions at CVS Pharmacy stores or using CVS Caremark’s mail-order option for maintenance medications.

For example, Aetna’s College Choice Health Plan in Illinois explicitly names CVS Caremark as its PBM, showcasing this synergy. With access to over 9,000 CVS Pharmacy locations nationwide, Aetna policyholders enjoy convenience and coordinated care—a key advantage of this ownership structure.

2. State Employee Health Plans

State governments often turn to CVS Caremark to manage prescription benefits for their employees, leveraging its extensive network and cost-saving capabilities. Here are some notable examples:

North Carolina State Health Plan: CVS Caremark serves as the PBM for the 70/30 PPO Plan, 80/20 PPO Plan, and High Deductible Health Plan. Recent updates, including the 2025 formulary, confirm this ongoing partnership, ensuring state employees have access to a broad pharmacy network and mail-order services.
Tennessee Partners for Health: Tennessee’s state employee medical plans, detailed on the state’s benefits website, use CVS Caremark to manage pharmacy benefits. The 2025 health options reaffirm this collaboration.
Minnesota State Employee Group Insurance Program (SEGIP): Since 2018, SEGIP has partnered with CVS Caremark, as noted in a 2017 announcement. Members receive prescription drug cards and access to CVS Caremark’s services.
Mississippi Department of Finance and Administration: Mississippi’s state employee health plan employs CVS Caremark, according to state documentation, providing affordable medication options for public workers.

These state plans highlight CVS Caremark’s role in supporting public sector healthcare, a critical segment of its client base.

3. Union Health Funds

Labor unions, which often provide health benefits to their members, also partner with CVS Caremark. A prime example is:

1199SEIU Funds: Serving healthcare workers in New York, the 1199SEIU Funds teamed up with CVS Caremark in 2024 to manage prescription benefits. This partnership enhances members’ access to pharmacies and digital prescription tools.

Unions value CVS Caremark’s ability to negotiate drug prices and offer convenient services, making it a popular choice for their health funds.

4. Private Insurance Companies

Beyond Aetna, CVS Caremark collaborates with other private insurers. One standout is:

MVP Health Care: Operating in New York and Vermont, MVP Health Care uses CVS Caremark as its PBM, as confirmed by its 2025 formulary page. Members can manage prescriptions online or visit network pharmacies, benefiting from CVS Caremark’s infrastructure.

This partnership demonstrates that CVS Caremark’s services extend to independent insurers, not just those under the CVS Health umbrella.

5. Elevance Health (Anthem Blue Cross Blue Shield)

Elevance Health, the parent company of several Blue Cross Blue Shield (BCBS) plans, including Anthem BCBS, currently uses CVS Caremark for its pharmacy benefits. A Drug Channels article notes that Elevance Health relies on CVS Health (likely CVS Caremark) but may shift to internal PBM resources post-2024. For now, this arrangement covers Anthem BCBS members in multiple states, though the future remains fluid.

Given that BCBS plans operate independently, not all use CVS Caremark—many partner with Prime Therapeutics instead. Elevance Health’s use of CVS Caremark is a notable exception.

6. California’s Valued Trust

The Valued Trust provides health benefits to California school districts and public agencies, with CVS Caremark as its PBM. This trust emphasizes the convenience of mail-order services and a robust pharmacy network, catering to educators and public employees.

A Note on Past Partnerships

The PBM landscape is dynamic, with insurers occasionally switching providers. For instance, Centene Corporation used CVS Caremark until 2024, when it transitioned to Express Scripts, as reported by Drug Channels. This shift underscores that the list of CVS Caremark’s clients can evolve, so it’s wise to verify current partnerships.

How to Confirm If Your Insurance Uses CVS Caremark

Not sure if your insurance plan uses CVS Caremark? Here’s how to find out:

Check Your Insurance Card: Look for CVS Caremark’s name or logo, often listed alongside pharmacy benefit details.
Visit Your Insurer’s Website: Navigate to the pharmacy benefits section—most plans disclose their PBM there.
Call Customer Service: A quick call to your insurer’s helpline can confirm your PBM.
Look for CVS Caremark Branding: Welcome packets, prescription cards, or online portals with CVS Caremark’s branding are a giveaway.

For example, North Carolina’s State Health Plan provides a dedicated CVS Caremark page for members, making it easy to identify the connection.

Benefits of Using CVS Caremark

Why do so many insurance plans choose CVS Caremark? Here are the key advantages:

Cost Savings: CVS Caremark’s negotiating power with drug manufacturers can lower costs, potentially reducing premiums or copays for members.
Integrated Services: For Aetna and other CVS Health entities, the integration of medical and pharmacy benefits enhances care coordination.
Extensive Pharmacy Network: With thousands of pharmacies, including CVS locations, members have ample options to fill prescriptions.
Digital Convenience: The CVS Caremark website and app allow users to check drug costs, order refills, and locate pharmacies.

These perks make CVS Caremark an attractive partner for insurers aiming to streamline pharmacy benefits.

Controversies Surrounding CVS Caremark

Despite its strengths, CVS Caremark isn’t without criticism. The PBM industry, including CVS Caremark, faces scrutiny over several issues:

Opaque Pricing: Critics argue that PBMs engage in “spread pricing,” charging insurers more than they pay pharmacies and pocketing the difference. This lack of transparency has fueled calls for reform.
Vertical Integration: CVS Health’s ownership of a PBM, pharmacies, and an insurer raises concerns about conflicts of interest. Could CVS Caremark favor CVS Pharmacy over competitors?
Legal Challenges: In 2024, the Federal Trade Commission sued CVS Caremark, Express Scripts, and Optum Rx, alleging they inflated insulin prices through rebate deals. This lawsuit underscores broader concerns about PBMs’ impact on drug costs.

These controversies don’t deter all insurers—CVS Caremark’s scale and efficiency remain compelling—but they highlight the complexities of its role.

The Future of CVS Caremark and PBMs

The PBM landscape is shifting. Elevance Health’s potential move to an internal PBM and Centene’s switch to Express Scripts signal that insurers are reevaluating their options. Regulatory pressure, such as the FTC’s actions, may also force changes in how PBMs operate. For CVS Caremark, staying competitive could mean enhancing transparency or expanding services like telehealth integration.

Meanwhile, its 20% share of U.S. prescriptions (per an X post) ensures it remains a heavyweight. Insurance plans will likely continue partnering with CVS Caremark, balancing its benefits against industry challenges.

Conclusion

So, which insurance uses CVS Caremark? The answer spans a diverse group: Aetna, state employee plans like those in North Carolina and Tennessee, union funds like 1199SEIU, private insurers like MVP Health Care, Elevance Health (Anthem BCBS), and trusts like California’s Valued Trust. While partnerships can shift—think Centene’s 2024 switch—these examples reflect CVS Caremark’s broad reach as of 2025.

CVS Caremark’s role as a PBM offers cost savings, convenience, and integration, but it’s not without controversy. Whether you’re an insurance member or a curious reader, understanding its clients and impact is key to navigating healthcare today. For the latest updates, check your insurer’s website or explore the linked sources above.