Question 1

I recently got my prescription card and my dependent's name is wrong. How do I correct this?

Accepted Answer

You can call the Fund office at (215) 561-2722 to give us the correct information, or Contact Us , leave us a message and someone will call you to get it corrected.

Question 2

How do I change my address or add or remove a dependent with the H&W Fund?

Accepted Answer

If you wish to change your address, or to add or delete a dependent, use the Notice of Change form which outlines what documentation is required. Mail the form and documentation to the Fund, attn: Eligibility 1816 Chestnut Street Philadelphia, PA 19103 or email benefits@philasd.org .

Question 3

Can I add my stepchildren to my prescription, dental and vision coverage?

Accepted Answer

We require the birth certificate of the child and the marriage certificate verifying that there is a valid marriage between the Fund's participant and the parent of the child along with a completed Notice of Change card.

Question 4

I turned in my paperwork to the Benefits department at 440, why don't you have it?

Accepted Answer

In order to receive benefits you must submit to the School District of Philadelphia and the PFT separately.

Question 5

What is the Family and Medical Leave Act (FMLA)?

Accepted Answer

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year. It also requires that their group health benefits be maintained during the leave. Employers must provide an eligible* employee with up to 12 weeks of unpaid leave each year for any of the following reasons: for the birth and care of the newborn child of an employee; for placement with the employee of a child for adoption or foster care; to care for an immediate family member (spouse, child, or parent) with a serious health condition; or to take medical leave when the employee is unable to work because of a serious health condition. If you believe you will need to apply for FMLA, the first step is determining eligibility. Complete the FMLA Cover Sheet to find out if you are eligible.

Question 6

How do I apply for FMLA?

Accepted Answer

The first step in the process is to complete the FMLA Cover Sheet and fax it to 215-400-4661 or email fmla@philasd.org at Employee Health Services. We encourage you to call a PFT Health and Welfare Fund coordinator for guidance and to help you apply.

Question 7

I will be 65 in a few months. What should I do?

Accepted Answer

It depends on your current situation – are you working or retired, do you have medical coverage or not. Refer to our 'Retirement' section and read 'Getting Started with Medicare'. Call a Fund Coordinator for additional guidance if your situation warrants it.

Question 8

I'm going on vacation and need to get my medication early?

Accepted Answer

Call the Fund at (215) 561-2722 and ask for a vacation override.

Question 9

What prescription plan is available for my spouse when COBRA ends?

Accepted Answer

This is a complicated question which will require the assistance of a Fund Coordinator. Give us a call.

Question 10

I'm having problems getting a prescription filled. What should I do?

Accepted Answer

Please call the Fund and ask to speak to a coordinator. We can resolve problems quickly for you.

Question 11

What should I do? I need an Epi-Pen (or another type of injectable medication):

Accepted Answer

Most Injectable medications are covered under your PFT CapitalRx prescription plan. Please call the help desk at 1-877-472-2779 to see if your injectable medication is covered.

Question 12

I am a current employee. What diabetic supplies are covered under my medical coverage and what are covered under my prescription coverage?

Accepted Answer

Medical Independence Blue Cross (Personal Choice or Keystone) will provide coverage for diabetic equipment and supplies purchased from a Durable Medical Equipment Provider. Durable Medical Equipment (DME) is any equipment that provides therapeutic benefits to a patient in need because of certain medical conditions and/or illnesses. Co-pays will apply. Equipment includes: Blood glucose monitors; Insulin pumps; Insulin infusion devices; and Orthotics and podiatric appliances for the prevention of complications associated with diabetes. Supplies include: Blood testing strips; Lancets and lancet devices; Visual reading and urine test strips; To find a provider under your Personal Choice or Keystone coverage, click here. Type in 'Durable Medical Equipment' in the search bar. CCS is a known reliable supplier and they can be reached at 800-726-9811 . To speak with an available Health Coach 24/7, call 1-800-ASK-BLUE (1-800-275-2583) (TTY: 711).* Prescription The Health and Welfare Fund benefit includes: Insulin Needles and syringes

Question 13

I'm on wage continuation and my direct deposit keeps changing. Why?

Accepted Answer

When you are working, you get 100% of your base pay, and summer reserve is deducted and set aside for summer (RESERVE ACCR). Wage continuation pays 75% of your base pay. Call and speak to a PFT health and welfare coordinator at (215) 587-6738 for more information. Review your pay statement

Question 14

Basic Vision: Do I need a form or a card?

Accepted Answer

Yes, if you are using the 'basic' coverage, you can download the Basic Reimbursement form or get one from your Building Rep or by calling the Health and Welfare department at (215) 561-2722 .

Question 15

Basic Vision: How often can I have an exam?

Accepted Answer

Once every calendar year.

Question 16

Basic Vision: How often can I purchase glasses?

Accepted Answer

Once every 2 calendar years unless there is a .5 diopter change in your prescription.

Question 17

NVA Vision: Do I need a form or a card?

Accepted Answer

No, the NVA program has gone paperless. Simply tell your participating provider that you are using NVA under the Philadelphia Federation of Teachers.

Question 18

NVA Vision: What is my NVA ID #?

Accepted Answer

A participating provider can use the members name to look them and their dependents up.

Question 19

NVA Vision: How often can I have an exam?

Accepted Answer

Once every calendar year.

Question 20

NVA Vision: How often can I purchase glasses?

Accepted Answer

Once every 2 calendar years unless there is a .5 diopter change in your prescription.

Question 21

NVA Vision: Where can I find a list of participating NVA providers?

Accepted Answer

Click here for the list of providers , or you can obtain a booklet from your Building Rep or by calling the Health and Welfare department at (215) 561-2722 .

Question 22

Keystone Vision: What is the Keystone Vision Benefit?

Accepted Answer

Members who have Keystone medical coverage have a Vision-Rider benefit administered by Davis Vision. To find a Davis Vision provider, click here.

Question 23

My child needs braces. How does the process work?

Accepted Answer

The lifetime service dollar maximum is $1,200.00 per member and eligible dependents and applies to all orthodontic services. The initial payment will be the equivalent of 25% of our liability. The remaining balance will be paid in quarterly increments, throughout the course of active orthodontic treatment.

Frequently Asked Questions

Quick Links

General Questions

Retirement & Medicare FAQs

Prescription Coverage FAQs

Wage Continuation

Vision Coverage FAQs

Dental Coverage FAQs