Prescription Benefit

This is a pharmacy benefit only and excludes drugs administered in a physician’s office or an outpatient setting.

Members and their eligible dependents can receive generic and preferred brand-name drugs at no cost when using a participating pharmacy that accepts Express Scripts. If you use a non-preferred pharmacy, you may be charged the amount the pharmacy bills above the Fund’s payment. Specialty drugs are available through the NYC PICA program and through the Fund’s prescription drug benefit.

Have your doctor prescribe generic and brand name drugs on the 1199SEIU Preferred Drug List (PDL). Share this list with your doctor, and work together to find the best covered option for you.

Please note that prior approval is required for certain medications. Certain medications are also subject to clinical program management.

Who Is Eligible?

Full-time and part-time members and their eligible family members are covered. For more information about your prescription drug coverage, please call our Member Services Department at (646) 473-9200.

Additional Resources