Prescription Benefit for Greater New York Members

Useful Resources

• Preferred Drug List (PDL)
• List of Participating Pharmacies
• CVS Caremark Mail Order Form
• Formulario de pedido por correo de CVS Caremark
• Specialty Medications
• Quantity Duration Drug List
• Prescription Reimbursement Form (Direct Claim Form)

There is no out-of-pocket cost for your prescriptions when you follow the Benefit Fund’s prescription programs:

• Use preferred drugs on the Preferred Drug List (PDL)
• Use participating pharmacies for short-term medications
• Order maintenance medications using The 90-Day Rx Solution. Then fill it through CVS Caremark Mail Service Pharmacy, or order and pick up your prescription at any CVS, Rite Aid, Walgreens or Duane Reade pharmacy nationwide.
• Some medications require prior authorization. If your doctor thinks you need a medication that is not on the Preferred Drug List, call CVS Caremark at (833) 250-3237 or CVS Specialty at (855) 299-3262.
• In order to continue to safeguard your health while providing you access to the medications you need, we use prescription programs such as the prior authorization list and a list of quantity duration drug classes.

Think Generics First!

Always ask your doctor to prescribe generic drugs from the Fund’s PDL where possible. The generic drugs listed on the Fund’s PDL have the same effectiveness as the name brands, but they cost much less. Remember, if your doctor prescribes a brand-name even though a generic is available, or a non-covered medication, you will have out-of-pocket costs.

For more information, call (646) 473-9200.

Who Is Eligible?

Eligibility Class I — Family Coverage

Eligibility Class II and III — Not covered for this benefit

Not sure what wage class you are?

Check the front of your Health Benefits ID Card, or click here for an explanation.

Greater New York members employed by New Jersey employers receive healthcare benefits through Aetna. Call (646) 473-9200 for questions about your benefits.

Additional Resources

• Summary Plan Description (SPD)
• Overview of Your Benefits:
  • Eligibility Class I & II (As of January 2019)
  • Eligibility Class I & II in Spanish (As of January 2019)
• Prescription Drug Reimbursement Form (Direct Claim Form)
• Summary of Benefits and Coverage (SBC)
• Pharmacist Authority to Administer Vaccines by State New