Get Yft Welfare Fund

Filling out the Yft Welfare Fund form for prescription drug benefits is a crucial process for members seeking reimbursement. This guide provides clear step-by-step instructions to ensure that you complete the form accurately and efficiently.

Follow the steps to fill out the Yft Welfare Fund form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the member’s name in the designated field. This should be the name of the person requesting the reimbursement.
3. Fill in the Social Security number, which is necessary for identification and processing of the claim.
4. Provide the home address, including street, city, state, and zip code. Ensure that all information is accurate to avoid delays.
5. Indicate the name of the school or building assignment to establish your association with the Yonkers system.
6. Enter the date of employment in the Yonkers system to verify eligibility.
7. Specify the date of birth of the member submitting the claim to further verify identity.
8. Provide the home phone number in case the Fund needs to contact you regarding your claim.
9. Indicate whether this claim is for the member only or for family coverage by selecting the appropriate option.
10. Enter the amount claimed for reimbursement, ensuring it aligns with the receipts attached.
11. Select the applicable health plan coverage type (Empire Plan Option, HMO, or other) and provide details if necessary.
12. Certify that no other health plan has paid for the prescriptions by signing the form and dating it.
13. Finally, attach the required documentation, including the original paid receipts or a computer print-out from the pharmacy. Ensure that each receipt includes the necessary details: patient's name, date of purchase, prescription number, name of drug, cost, and prescribing doctor's information. The pharmacy's name, address, and phone number must also be included.
14. Once all sections are complete and documentation is attached, save your changes, download, print, or share the form as needed.

Complete your Yft Welfare Fund form online today to ensure timely processing of your reimbursement!