Direct Reimbursement Claim

Direct Reimbursement Claim

SUBMIT ONLINE: Please fill out the information below and submit your claim.
SUBMIT BY MAIL: Click to download and print this form to submit by mail.

Please verify your eligibility prior to submitting a direct reimbursement claim. If eligible for service and you use a non-participating provider, reimbursement is $125 or the actual charge, whichever is lower. Reimbursement will be $20 for an eye exam only, when no other services are rendered.

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endpoint=”oon_claim_uft_scob_app” confirm_email=”yes”]

Thank you for submitting your UFT Welfare Fund Direct Reimbursement optical claim. Your claim has been received and will be processed by the Fund’s claim administrator, General Vision Services (GVS). If more information is required about this claim, GVS will notify the UFT member by mail.

Most claims are processed within 10 business days. As the payment of approved claims will be sent to the member’s address on record, please allow separate time for mailing.

[/gvs_form]