USAble Mutual Insurance Company

Pharmacy Benefits

If Caremark is the pharmacy benefits administrator listed on your ID card and you need more information regarding your pharmacy coverage, call 1-888-293-3748.

Your prescriptions claims history — including prescription number, date filled, prescriber, quantity, pharmacy, amount paid by you and amount paid by your pharmacy plan — can be found within My Tracker, our member self-service center.

Pharmacy Links

Network Pharmacy Search
Search for a network pharmacy by name, city, state or zip code. Maps and driving directions are provided.

Specialty Drugs
A description of the program that covers injectable and select oral medications.

Mail-Order Drugs
A description of the mail-order option some employers have chosen for their employees and a link to the mail-order form.

Using Your Pharmacy Benefits
How to use your benefits and the advantages your pharmacy plan offers you.

Save Money with $4 Generics
Where to buy them.


Prescription Claim Form (PDF)
Printable form in portable document format (PDF).

Prior Authorization Form for Prescription Drugs (PDF)

Drug Lists

Note: Your plan's covered drug list may vary from this standard formulary. Call the Customer Service number on your ID card or consult your group administrator to verify this formulary.

2015 Metallic Drug List (PDF)

2015 Standard Formulary (PDF)

2014 Standard Formulary Preferred Drug List (PDF)

2015 Value Formulary Pocket Guide (PDF)

2015 Value Formulary (PDF)

2014 Value Formulary Preferred Drug List (PDF)

Maintenance Drugs (PDF)
Medications considered to be necessary for long periods of time.

Prior Authorization List (PDF)
Medications that require prior approval. For authorization, call 1-877-433-2973.