Prescription Benefit for National Benefit Fund Members
The Preferred Drug List (PDL)
Have your doctor prescribe preferred 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. If your doctor prescribes a drug in a category covered by the Benefit Fund but you don’t see it on the Preferred Drug List, just ask your doctor to prescribe any generic medication or a brand-name if there are no generics available.
CVS Caremark
We encourage you to make an account at CVS Caremark to manage your prescriptions, find participating pharmacies—which are not limited to CVS—and more.
Maintenance Medications
Maintenance medications – those you take on an ongoing basis for conditions such as high blood pressure, diabetes or high cholesterol – may be filled as 30-day or 90-day supplies. The Fund’s pharmacy network offers easy and convenient pharmacy choices for filling maintenance medication prescriptions. Your provider can e-prescribe (mandated by NYS law) prescription orders for maintenance medications to CVS, Walgreens, Duane Reade or other participating pharmacies.
CVS retail pharmacies are offering the updated COVID-19 vaccines to patients nationwide.
Appointments can be scheduled online via CVS.com, through the CVS Health app, or patients can walk into CVS retail pharmacies. Prescriptions from outside prescribers is not required in any state to receive a COVID-19 vaccine. CVS pharmacists will answer any questions patients may have about the vaccine.
Prior Authorization
Some medications and services 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.
Specialty, Step Therapy and Quantity Duration Drugs
In order to continue to safeguard your health while providing you access to the medications you need, we use prescription programs such as our specialty medications list and drug quantity management drug list.
Who Is Eligible?
Family Coverage — Wage Class I
Wage Class II and III are not covered
Not Sure What Wage Class You Are?
Check the front of your Health Benefits ID Card, or click here for an explanation.
Additional Resources
Access Care from the Comfort of Your Home
If you are a National Benefit Fund, Greater New York Benefit Fund or Home Care Benefit Fund member, you can schedule a virtual visit with any hospital or provider in our 1199SEIU Benefit Fund network, wherever you may be. This is in addition to your Teladoc benefit.
