79 To get started, visit go.virta.com/niamcot and select "Join Now" or "Check Eligibility" or call 844-847- 8216 to begin the enrollment process. This process includes a video appointment with a Virta provider and can take one to three weeks. Contraception The Plan covers certain prescribed contraceptives and contraceptive devices for eligible female participants with no copayment, coinsurance or deductible. In all cases the drug or other contraceptive item must be prescribed by a physician. Prescribed generics and single source brands will be covered with no cost-sharing. Standard time limits for dispensing of such items apply. Please contact CVS Caremark directly at 866-282-8503 if you have questions about what prescribed items are covered. Male Androgens The Plan provides coverage for medical treatment of erectile dysfunction when caused by an established medical condition. This includes coverage for prescribed male androgens (testosterone and erectile dysfunction drugs). Prior authorization and Medical Necessity are required for coverage. Your physician can call CVS Caremark directly at their toll-free number 855-240-0536 to request approval. They will be required to provide supporting clinical information, which CVS Caremark will review to determine whether the Medical Necessity standard has been met. If Medical Necessity is confirmed, the Plan will allow covered prescriptions, subject to a 10-pill per month limit for on demand products, or a 30-pill per month limit for daily use Cialis 2.5 mg or 5 mg. If CVS Caremark determines that the use of a male androgen is not Medically Necessary, coverage of the prescribed drug will be denied. Compounded Medications A compounded medication is a medication that is made by combining, mixing or altering ingredients, in response to a prescription, to create a customized medication that is not otherwise commercially available. Any medication classified as a compounded medication that costs more than $300 will require prior authorization before it is covered under the terms of the Plan. Bulk powders and high-cost proprietary bases are not covered under the Plan. One fill of a compound medication is allowed in a 34- day period. If your physician prescribes a compound medication for you, your Spouse, or your Eligible Dependent Children, you should ask him or her to call CVS Caremark at 800-294-5979 to request prior authorization before the prescription is filled. GLP-1s Except where a participant has a history of diabetes, the Plan requires prior authorization for the use of GLP-1 and GLP-1 combination drugs for diabetes treatment (e.g., Ozempic, Trulicity, and Mounjaro), A participant is considered to have a history of diabetes for this purpose if the participant is currently using, or has in the past used, a drug other than a GLP-1 drug for the treatment of diabetes. GLP-1 drugs for the treatment of weight loss (e.g., Wegovy, Saxenda, and Zepbound) must be prescribed by Virta Health.