As a PGH Global Student, you will have access to the UnitedHealth Allies program that will allow you to obtain your necessary prescriptions at a reduced price.
To submit a claim for reimbursement regarding a prescription that you paid for out of pocket, please print a copy of the Prescription Claim Form.
Prescription Claim Information Check List
Information and Documents
- Prescription Reimbursement Claim Form
- Date prescription filled
- Name and address of pharmacy
- Doctor name or ID number
- NDC number (drug number)
- Name of drug and strength
- Quantity and days’ supply
- Prescription number (Rx number)
- DAW (Dispense As Written)
- Amount paid
- Clip, do not staple, all bills to the completed form.
- Make sure all bills or itemized receipts indicate:
- A diagnosis code
- Procedure code
- Date of service
- The provider’s tax ID number.
- Mail To:
P. O. Box 809025
Dallas, TX 75380
- Fax To:
This information can usually be found on the receipt which is stapled on the outside of the packaging or in some cases located inside. Contact your pharmacist for more information.
United Health Allies
The UnitedHealth Allies program is included with your student health insurance policy. Your UnitedHealth Allies ID card will be delivered along with your student health insurance ID card. UnitedHealth Allies offers discounts on prescriptions at the pharmacy and through the mail, in addition to a multitude of other healthcare needs.
Once you have received your UnitedHealth Allies card, log onto www.sr.unitedhealthallies.com, and register to begin using the program immediately.
Prescription Benefits to the UnitedHealth Allies program:
- Save an average of 20% off the retail price of your prescriptions when you visit a participating retail pharmacy
- Save an average of 50% off the retail price when you use the mail pharmacy service for your recurring prescriptions, and enjoy the convenience of home delivery.
- 24 hour telephone access to pharmacist
- Access to online features:
- Price checks
- Prescription drug guide
- Online refills
- Drug interaction information
- And more!
We are confident that the United Allies program can help you stretch your dollar on prescription drugs and other services.
For more information on the prescription drug and other benefits of UnitedHealth Allies please review the UnitedHealth Allies Member Handbook
* UnitedHealth Allies is not insurance. UnitedHealth Allies provides discounts at certain health care providers for medical services. UnitedHealth Allies does not mak