Options for changing your Medicare Part D prescription drug plan
Disclaimer:
The UFT Welfare Fund cannot provide guidance on finding a private Medicare Part D drug plan. Retirees who pursue that open-market option should proceed cautiously since:
- A less-expensive plan likely will not be as robust in terms of covered drugs and the size of the pharmacy network.
- The UFT Welfare Fund’s pharmacy department will not be able to assist with pharmacy issues because a private plan will not converse with staff.
- While the UFT Welfare Fund will continue to reimburse members who obtain their own drug plan up to $900 a year for Part D prescription drugs, the process is not automatic as it is now. Retirees will have to file a separate form with the UFT Welfare Fund.
If you are satisfied with your current drug coverage, you don’t need to do anything. Your current coverage will automatically carry over. For questions about drug coverage, you can contact the UFT Welfare Fund at 212‑539‑0500 or email rxhelp [at] uftwf [dot] org (rxhelp[at]uftwf[dot]org).
Instructions for completing the Retiree Health Benefits Application/Change Form and changing your Part D Prescription Drug Plan during the November 2026 Annual Fall Transfer Period
Purpose: Use these instructions if you want to drop your GHI Senior Care Optional Rider prescription plan (through EmblemHealth) and replace it with a non-city Part D drug plan that you have purchased on the individual private insurance market. Changes take effect January 1, 2027.
** These instructions are intended for UFT retirees who are covered by the GHI Senior Care Health Plan.
Make informed decisions:
For some more useful information, view a presentation given to the RTC in October 2026 by the Medicare Rights Center:
The presentation will give you helpful ideas and practical questions that you may want to ask if you decide to compare Medicare Part D prescription drug plans on the open market.
- Learn more about the Part D prescription drug rider
- Read about optional rider choices for retirees with GHI Senior Care
Before You Begin
Before dropping your GHI Senior Care Optional Rider Prescription Plan, make sure you already have a creditable Part D prescription drug plan in place.
You must purchase this plan yourself on the individual private insurance market, coinciding with the day you terminate your city-sponsored rider.
Completing the Form
The Retiree Health Benefits Program Application/Change Form can be found on the city's Office of Labor Relations page.
Page 1:
Section A – Enrollment
- Check the box for "Annual Fall Transfer Period (Effective January 1)."
Section B – Change Of
- Check the box for "Optional Prescription Drug Benefits" and mark the box for "Drop."
- If you want to keep ONLY the 365-day hospitalization rider benefit, check the box for "365 Day Rider Benefits (GHI Senior Care Only)" and mark the box for "Add."
Section C – Retiree Information
- Fill in all personal information.
- Leave blank "Name of Current City Health Plan." (You are not changing health plans, only the prescription drug plan.)
- Indicate your MBI number found on your Medicare ID card.
- Check "Yes" for "Are you Medicare eligible?"
- Check the box for your pension system — for most UFT members this is TRS; for others it may be BERS.
- In the field for "Name of Union or Welfare Fund," write UFT.
Section D – Family Information
- Complete any dependent information.
Attach a copy of the Medicare card(s) for any Medicare-eligible spouse, domestic partner, and/or disabled dependent, that is being added to the coverage.
Page 3:
Top of Page 3 - Fill in member’s last name and last four digits of SSN.
Section E – Health Plan Election
Leave the first part of Section E, “Non-Medicare Plans” blank.
In the middle portion, titled "Medicare Supplemental Plans":
- Check the box indicating your current supplemental health plan. For Medicare retirees making this change, the name of the plan is GHI/Anthem Senior Care.
- Under the subheading "Optional Rider Options":
- If you are using this form to notify OLR that you are dropping only the Optional Rider prescription plan, leave the "Check here for Optional Rider Benefits" box blank.
- If you want to keep the 365-day hospitalization rider benefit (at a current cost of $3.38 per month), check the "365-Day Rider Benefits" box.
Section F
- Sign your name.
- Fill in the date.
Submitting Your Application
You can submit your completed form and documents to OLR in one of three ways found at the upper right-hand side of the Health Benefit Program Retiree Application/Change Form:
- Fax (fastest method): Fax all documents to OLR at 212-306-7373.
- Upload online: Upload your documents through OLR's website. This is a good option, though it typically takes longer than faxing it.
- Mail: Mail your documents to the address listed on the Change Form.
Important Reminders
- Keep copies: Make copies of everything you send to OLR.
- If uploading via LeapFile: You will not receive an email confirming that your documents were received. However, you will see an on-screen notification confirming a successful upload. Take a screenshot of that confirmation and save it as proof that you uploaded your documents.