All eligible in-service UFT members and their dependents have prescription drug coverage through the UFT Welfare Fund. There are no waiting periods for this coverage.
In fact, after enrolling in the Welfare Fund, newly enrolled members who are awaiting their Welfare Fund Express-Scripts (ESI) Prescription ID drug cards can purchase the prescription drugs they need and, once their cards arrive, submit the original receipts to the Fund for reimbursement.
There are two types of drugs: acute illness drugs and maintenance drugs. Acute illness drugs are those that you need immediately, such as an antibiotic. Your local pharmacy dispenses this type of drug to you.
Maintenance drugs are those that are taken over extended periods of time, such as antihistamines for allergies or drugs for high blood pressure. Typically, you will use the ESI Home Delivery service because you will save money and convenient delivery is made to your home. However, there are certain maintenance drugs, such as narcotics or controlled medications, that can only be dispensed in a 30-day supply at the local pharmacy.
- Obtain drugs at any participating pharmacy
- 30-day supply
- Tier I (Generic) $5.00
- Tier II (Preferred Brand) $15.00
- Tier III (Non-Preferred Brand) $35.00
After the original prescription and two (2) refills, members must use ESI Home Delivery Service for a 90-day supply.
ESI Home Delivery Service
- Obtain maintenance drugs by mail
- 90-day supply, in three (3) pre-packaged items of maintenance drugs
- Copayments: Tier I (Generic) $10.00
- Tier II (Preferred Brand) $30.00
- Tier III (Non-Preferred Brand) $70.00
Cost Care Program
- For members who exceed $1,200.00 per year in prescription costs, this program allows members and their dependents to obtain medication in a cost-effective manner.
NYC PICA Drug Program
- Injectible and Chemotherapy drugs with a $100 annual deductible. For Information, call 800-467-2006.
For prescription drug emergencies during hours when the Welfare Fund is closed, members should call Express Scripts (ESI) at: 1-800-723-9182.
The UFT Welfare Fund Prescription Drug Plan is administered by:
Express Scripts Inc.
One Express Way
St. Louis, Missouri 63121
For more information on the prescription drug plan, please select one of the following:
You can buy the prescription drug you need now. Once you receive the card, submit an original receipt to the Fund for reimbursement. Use the Drug Reimbursement Form for in-service members or call the Forms Hotline at 212-539-0539 to receive them by mail.
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 Cost Care Program on January 1st of the calendar year. Cost Care participants who want brand-name drugs must pay the cost difference between the brand name and the generic if available, plus the applicable copay.
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.
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.
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 the prescription. After the second refill, to continue using the drug, you must obtain a new prescription from your physician for 90 days supply or 100 pills/capsules, whichever is greater, and then use the ESI Home Delivery Service.
Mail the original prescriptions in the postage paid envelope along with a completed order form to the Express-Scripts Home Delivery Service.