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NYS Co-Pay Reimbursement Enhancement


In May, 2008, a mailing was sent to all NYS employees covered under the Administrative, Institutional & Operational units along with the Division of Military & Naval Affairs, Roswell Park Cancer Institute Corporation and the NYS Liquidation Bureau notifying them of an enhancement to the EBF Rx Co-pay Benefit retroactive to January 1, 2008.


The current $100 RX Co-Pay Benefit reimburses NYSHIP prescription drug card co-pays once annually after accumulating $400 in receipts for prescription drug co-pays. The new enhanced benefit allows members to submit prescription receipts that are less than the co-pay amount required under the prescription drug plan. This means that if the drug co-pay is $10 and the prescription written by your doctor costs only $7, the $7 can now be applied towards the $400 you must accumulate before submitting receipts to the Benefit Fund.


For members to take advantage of this valuable benefit, they must participate in the NYS Health Insurance Program. Once you have accumulated prescription receipts totaling $400, submit the original receipts or an itemized printout from your pharmacy, along with a RX Co-Pay reimbursement form to the Benefit Fund. If you do not accumulate $400 before the end of the year, you may submit your claim after December 31st for what you did pay over $300. The receipts must be for the current calendar year (January - December) and a copy of your Empire Plan or HMO insurance card must accompany the form and receipts.


The RX Co-pay Reimbursement form may be downloaded from the Fund's Website. Go to the home page, click on the library, all EBF forms, and click on the RX Co-pay Reimbursement Form (State).


Please remember that prescriptions must be for you and your dependents and dispensed by a licensed pharmacist. Over the counter drugs are not covered under this benefit.


Questions regarding the RX Co-pay Benefit can be answered by contacting the Fund at 1-800-323-2732 and speaking with a customer service representative.