Prescription Copay Information

Prescription Copay Reimbursement Information


Please find information relating to the SBF Copay Reimbursement Benefit covered under the Buffalo Teachers Federation below. If you have any questions, please contact the Supplemental Benefit Fund office at (716) 881-5462.

 

The SBF offers a reimbursement benefit for all teacher members and their dependents on prescription copays. The benefit reimburses up to $2.00 per Rx script, with a $100.00 yearly maximum per person.  

When submitting for the SBF prescription benefit:

  1. Download and print the Copay form below. Claim forms are also available in your school or by calling the SBF Office at (716) 881-5462.
    • Supplemental Benefit Fund Rx Copay Claim Form
  2. Complete all the patient and subscriber information on the claim form.
  3. Obtain and attach a copy of the computer generated roster from your pharmacist to the claim form.
  4. Please be sure the roster includes:
    • Name of Patient
    • Rx Purchase Date
    • Name of Each Rx
    • Name of Provider
    • Cost Paid for Rx
  5. Make a copy for your records.
  6. Mail the original copies to the Buffalo Teachers Federation - Supplemental Benefit Fund, 271 Porter Avenue, Buffalo NY 14201

S5 Box

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