The following is important information which
every MILA Member covered under the Premier
Plan should keep in mind when accessing
medical services, behavioral health services or
prescription drugs. This information will help
you to obtain the highest level of benefits from
the Premier Plan while ensuring that you obtain
the care you require.
In-Network Service
Each Claim Administrator has In-Network providers for
the use of Plan Participants.
- The CIGNA network is a broad based preferred
provider network from which MILA Members may
select any participating physician, hospital or other
provider if that provider has been contracted for the
service. For example, one might select a cardiologist
to treat heart ailments.
- The CIGNA network includes in-store health clinics
in select locations under the brand names of:
- The CIGNA network includes in-store health clinics
in select locations under the brand names of:
- Little Clinic in Kroger and Publix Stores,
- RediClinic in Wal-Mart and elsewhere,
- Sutter Express Care in California, and
- TakeCare Health Clinics in Walgreens and Eckerd Stores.
These clinics generally offer extended hours of operation
(often 24 hours), they do not require appointments, they
generally see patients within one-half hour or less, they
offer a limited menu of services in the treatment of minor
illness or injury, and the services are performed by nurse
practitioners under the direction of a staff physician – all
for a primary care copay of $15.
-
The ComPsych network of behavioral health
providers include psychiatrists, psychologists,
certified psychological counselors and so forth.
As in the CIGNA network, MILA Members may
select any In-Network provider with the appropriate
credentials for treatment.
-
The Caremark® network of pharmacies includes all
the retail pharmacies with which Caremark® has a
contract. If the Caremark® logo is displayed, the retail
pharmacy is available to MILA Members. MILA has
been assigned to one mail service pharmacy and, at
this time, that pharmacy location is the exclusive
provider of mail service to MILA Members.
-
Although you are responsible for complying with the
Plan’s medical management procedures, In-Network
providers generally are familiar with these procedures
and will assist you in this process.
The In-Network providers have been selected based upon
that provider’s credentials and the quality of service which
that provider has delivered in the past. The provider must
agree as a condition of participation to give the network
a discount on the cost of service. However, quality service
is the most important contributor to lower Plan cost. If the
service is appropriate to the Member’s medical needs, the
Member will recover faster and require less medical service.
Not only will this result in lower total Plan cost, but it
will create a more satisfactory experience for the Member.
