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If I am married to another UFT member, do I get additional optical benefits?
Members and their spouse/ domestic partner who are also members are entitled to special coordination of benefits (SCOB). This entitles each eligible family member, upon request at the same time for two (2) covered services, one (1) service under each...
Are contact lenses covered under the optical plan?
Yes, the Fund will pay for contact lenses as per the fee schedule, but not in addition to glasses.
What is the Cost Care Program?
When the Fund pays out in excess of $1,200 for 12 months from December through November for an individual member or family (or $2,400 for SCOB – a member with a spouse/domestic partner who is also an in-service member), the member is placed in the...
How can I get reimbursed for medication I bought when I was on vacation?
You may submit a Prescription Drug Reimbursement Form (also available by calling our Forms Hotline at 212-539-0539) with a copy of the paid pharmacy receipt, indicating the patient name, drug name, dosage and quantity.
Why isn’t my diabetes drug covered?
It is covered, but not by the Welfare Fund. By state law, health plans cover diabetes drugs and ancillary devices. Please call your health plan for details.
How does the mail order program work for prescription medications?
Maintenance medications (those taken regularly over an extended period) cannot be filled in monthly quantities after they have been filled three (3) times (original prescription plus two (2) refills), regardless of the number of refills indicated on...
I am a GHI subscriber and I need some medical equipment (known as durable medical equipment). Can I file for reimbursement with the UFT Welfare Fund?
First, submit your claim to GHI for reimbursement. If GHI reimburses you minus the $100 deductible, in-service members can then submit a completed Welfare Fund GHI DME deductible reimbursement form, along with the GHI explanation of benefits to the...
I just purchased a prescription appliance and HIP rejected the claim. Can I submit this claim to the UFT Welfare Fund?
Yes, the Welfare Fund will reimburse for certain covered appliances for in-service members that meet our medical advisor’s and HIP guidelines. The benefit pays 80 percent of reasonable and customary charges after a $25 annual deductible per person.
Is there a cap on the Welfare Fund reimbursement for prescription appliances for HIP subscribers?
Yes, this benefit is capped at $1,500 a year and $3,000 for a lifetime.
I had surgery and now I am being billed for the anesthesia because HIP rejected the claim. Can I file with the Fund for payment?
Yes, the Welfare Fund pays 80 percent of reasonable and customary charges when the benefit is not covered by HIP PRIME for in-service members. To file for payment, you need to complete a Welfare Fund anesthesia claim form and attach an itemized paid...