CSEA Prescription
Drug Co-Pay Benefit
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The CSEA Employee Benefit Fund reimburses NYSHIP prescription drug card co-pays and covered prescriptions less than the co-pay once annually up to a maximum of $100 per family* per calendar year. To obtain the maximum benefit of $100, members must wait until their co-pay expenses reach $400 before filing a claim.
For purposes of the Prescription Drug Co-pay Benefit, "Family" includes Domestic Partner.
What is the benefit?
- Members who are enrolled in the New York State Health Insurance Program (either the Empire Plan or Health Maintenance Organization) are entitled to reimbursement once annually for NYSHIP prescription drug co-pays only for themselves and their dependents.
- Only one claim per calendar year (January - December) is processed. To obtain the maximum benefit, wait until your co-pay expenses reach $400 before filing your claim.
- If you do not accumulate $400 before the end of the year, submit your claim after December 31 for what you did pay over $300. The deadline for submission is March 31 of the following year for the co-pays accumulated during the previous Calendar Year.
Submit your completed form with original receipts or itemized pharmacy printout clearly indicating the co-pay amount, and a photocopy of your Empire Plan or HMO insurance card. Cash register receipts, cancelled checks and credit card receipts are not acceptable. The Fund will then send the check to the member. Prescriptions must be dispensed by a licensed pharmacist.
For more information please go to the CSEA Employee Benefit Fund website.
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