|UNITE HERE HEALTH –
218 S. Wabash, 4th Floor
Chicago, IL 60604
|Ascension Rx - Resurrection Pharmacy
7447 W. Talcott, Professional Building
Chicago, IL 60631
You will be able to get up to a 90-day supply for Smart Formulary Drugs at any of our 2 free pharmacies.
|Prescription Drug Benefits - What You Pay|
|Prescription Drug Benefits||Per Prescription|
|Formulary Prescription Drug Benefits at the UNITE HERE HEALTH – Health Center and the Ascension Rx - Resurrection Pharmacy (up to a 90-day supply)|
|Prescription Drugs (excluding select brand drugs)||$0|
|Select Brand Drugs*||50%|
|Formulary Prescription Drug Benefits at Network Retail Pharmacies and Mail Order||Retail Pharmacy up to a 34-day supply||Mail Order Pharmacy up to a 90-day supply|
|Preventive Healthcare Services Drugs||$0|
|Generic and Some Brand Drugs||$5|
|Select Specialty and Select Biosimilar Drugs*||Not covered||Generic||Brand|
|Non-Formulary Prescription Drugs and Supplies||Not covered, unless an exception is approved|
|* Current pharmacy benefit provider will actively manage and determine drugs in tier. Specialty drugs are only available through the specialty mail order pharmacy. However, effective January 1, 2022, if you take specialty medications as part of your HIV treatment plan, you may be able to receive an exception to use your network retail pharmacy instead of the specialty pharmacy.|
Brand name drug with generic available
If you or your healthcare provider insist on a brand name drug when a generic equivalent is available, you must pay the generic copay plus the difference in cost between the brand and generic drug.
If the generic copay is $10, the brand name drug is $80 and the generic is $50, you will pay $40. $10 copay plus $30 difference in cost.
For questions about your drug benefits, call: (844) 813-3860
Out of Network
Martins/Giant/Stop & Shop
Kroger/Fred Meyer/Fry's/King Soopers
Certain independent local pharmacies
Remember: Don't go out of network, you will pay 100% of the costs!
UNITE HERE HEALTH members can get many commonly used prescription drugs for FREE.
To see if the free pharmacy carries your medicine, visit drugs.hospitalityrx.org and:
You can still go to any network pharmacy for all covered prescription drugs at the same copays.
Ascension Rx - Resurrection Pharmacy
7447 W. Talcott Avenue, Professional Building
Chicago, IL 60631