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.

What is Step Therapy? [pdf, 1056 KB]


Language Assistance Available [pdf, 561 KB]

Prescription Claim Form [pdf, 234 KB]
Printable form in portable document format (PDF).

Prior Authorization Form for Prescription Drugs [pdf, 120 KB]

Texas Prior Authorization Form [pdf, 240 KB]
Please submit completed form to our secure fax line 501-378-6980. For further questions please contact us at 1-888-293-3748

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.

2016 Standard Formulary [pdf, 1467 KB]

2017 Standard Fomulary [pdf, 1382 KB]

2017 Standard Preferred Drug List [pdf, 209 KB]

2016 Maintenance Drug List [pdf, 706 KB]

2016 Metallic Formulary [pdf, 3934 KB]

2017 Metallic Formulary [pdf, 3865 KB]

2016 Standard with Step Therapy Formulary (Formerly known as Value Formulary) [pdf, 1465 KB]

2017 Standard with Step Therapy Formulary (Formerly known as Value Formulary) [pdf, 1468 KB]

Prior Authorization List [pdf, 598 KB]
Medications that require prior approval. For authorization, call 1-877-433-2973.