Prescription Drugs

Quick Reference

Website Call CapitalRx customer service: 833-692-2779 Find a provider

Coverage Highlights

  • CapitalRx administers the Fund’s prescription drug plan
  • You must use an CapitalRx network retail pharmacy or the CapitalRx mail order program to receive prescription drug benefits
  • Prescription drugs purchased from non-network retail pharmacies or outside of the mail order program are not covered
Drug Tier Retail (up to a 30-day supply) Mail Order (up to a 90-day supply)
Generic $10 copayment $20 copayment
Preferred Brand Name $30 copayment $60 copayment
Non-Preferred Brand Name $50 copayment $100 copayment
Annual Out-of-Pocket Maximum (separate from the Medical Plan) $1,000 individual $2,000 family $1,000 individual $2,000 family


Heat and Frost Insulators Local No. 33 Health Fund SPD