Close
Close
Close
Close
Close

ExtraCare Pharmacy & Health Rewards

Want to opt out?

You or your dependent will miss the chance to earn up to $50 ExtraBucks® Rewards this year.*

Fill out the form below to opt yourself or a dependent out ExtraCare Pharmacy & Health Rewards®. Once you do, you'll no longer earn rewards for prescriptions filled at CVS Pharmacy®.

If you don't have the Rx number from a medication you've filled at CVS Pharmacy in the last year, contact your local pharmacy or call 1-800-SHOP CVS.

Insert title here

ExtraCare Card Number Locations

The Extracare card number is located at the bottom of the card
 

Opt a Patient Out of ExtraCare Pharmacy & Health Rewards™

*= Required Field

Please provide the following information. You'll find it on your CVS Pharmacy prescription label and on your ExtraCare card.

  • Leave off leading letters and zeros.  View sample
  • Patient Date of Birth *    
  • Leave out dashes and spaces. If you have an ExtraCare Health card you can enter that here. View sample
  • Please tell us who is opting out: *

*You must enroll in both the ExtraCare® program and the ExtraCare Pharmacy & Health Rewards® program to earn $5 ExtraBucks® Rewards when you earn 10 credits. See program rules for details Rewards cannot be earned on any prescriptions purchased in AR, NJ or NY; any prescriptions transferred to a CVS Pharmacy® in AL, MS or OR; any controlled substance prescriptions purchased in HI or LA; or where otherwise prohibited by law. CVS Pharmacy reserves the right to modify or terminate the ExtraCare Pharmacy & Health Rewards program.