All eligible in-service UFT members and their dependents have prescription drug coverage through the UFT Welfare Fund.
There is no waiting period. After enrolling in the Welfare Fund, members who are waiting for their Express Scripts prescription ID drug cards can purchase the prescription drugs they need and, once their cards arrive, submit the original receipts to the Welfare Fund for reimbursement.
Prescription drug copays
The Welfare Fund has a three-tier copay structure for generic, preferred-brand and nonpreferred-brand medications. You can save money by using generics (Tier 1) or preferred-brand medications (Tier 2) whenever possible, but this is a decision between you and your doctor. Nonpreferred-brand drugs (Tier 3 — those not listed on the Welfare Fund’s formulary) have the highest copays.
At the pharmacy, if your doctor has not indicated that the pharmacist must dispense a brand-name drug, you will get a 30-day supply of a generic drug for $5 provided one is available.
Your doctor may prescribe two types of drugs:
- Acute illness drugs, or drugs you need immediately, such as antibiotics. Your local pharmacy dispenses this type of drug. You can fill your prescription at the pharmacy the first time and then get up to two refills if your doctor has indicated them.
- Maintenance drugs, or drugs taken over extended periods of time, such as inhalers to treat asthma or drugs for high blood pressure. The Welfare Fund provides for a 90-day supply of maintenance drugs for the price of a 60-day supply (two copays) through the Express Scripts Home Delivery Service or the Smart 90 Walgreens/Duane Reade retail network. You can get up to three refills — a year’s supply — on one prescription.
Certain maintenance drugs, such as narcotics or controlled medications, can only be dispensed in a 30-day supply at a local pharmacy.
New York City PICA Program
The city-administered PICA Drug Program, rather than the UFT Welfare Fund, covers injectables (including EpiPen) and chemotherapy drugs. The New York City PICA drug plan card should be used to obtain these types of drugs. The PICA program is administered by Express Scripts, which can be reached at 800-467-2006
Under state law, diabetes drugs are covered by your health insurance, not by the Welfare Fund drug plan. Show your health insurance card at the pharmacy when filling these.
Express Scripts mobile app
Members should download the Express Scripts mobile app on their cellphones. The app provides a host of services, including getting refills and renewals, and a section called Medicine Cabinet to check drug interactions, claims and history, which is great for reviewing a drug you have taken in the past. The app also has a copy of your prescription ID card.
Retail option for long-term drugs
Maintenance drugs can be filled at any Walgreens or Duane Reade pharmacy for the same cost as through Express Scripts home delivery. Your provider can electronically send your prescription to one of these pharmacies that is convenient for you. Your provider should include your 10-digit UFT Welfare Fund ID number, which can be found on your prescription card, when sending your prescription to the pharmacy. The Smart 90 Walgreens/Duane Reade retail network is authorized to dispense up to a 90-day supply, with up to three refills, within one year from the date the prescription is written. If further medication is necessary, a new prescription must be obtained.
Drugs in all three tiers can be filled as long as they are deemed maintenance medications. To find a pharmacy, visit Express Scripts, select “Find a Pharmacy” and enter your ZIP code. You can also call 800-723-9182.