MILA : WHAT IS COVERED

	Benefits Summary


	What Is Covered

Explanation of Terms

Covered Medical Services

Other Medical Services

Non-Routine Care and Services

What is Covered Under the Behavioral Health Program

The Prescription Drug Program

Types of Medications

Prescription Brand Deductible and Generic Substitution

Purchasing Prescriptions

Using an In-Network Retail Pharmacy

Using an Out-of-Network Retail Pharmacy

Using the Mail Service

When You Must Use the Mail Service

Exceptions to Mandatory Mail Service

Paying for Your Prescription Drugs through the Mail Service Pharmacy

Covered Medications

When to Get Prior Approval for a Prescription

Medical Expensese Not Covered Under the Plan

Charges Not Covered in the Behavioral Health Program

Charges Not Covered in the Prescription Drug Program

Coordination of Benefits

Third Party Reimbursement and Subrogation


	Participation Under the Plan


	Claims and Appeals


	Your Rights Under ERISA


	Administrative Information


	Glossary

WHAT IS COVERED

Purchasing Prescriptions

When you receive a prescription for medication from your physician, you may fill it through any of the following:

The Caremark® retail network of participating pharmacies for up to a 30-day supply;
Any other retail pharmacy that is not a Caremark® retail pharmacy for up to a 30-day supply; or
Through the Caremark® Mail Service Pharmacy for up to a 90-day supply.

Generally, you may refill a prescription through a retail pharmacy only once. After that, you must use the Caremark® Mail Service Pharmacy in order for the Plan to cover your prescription. The mail service program generally provides you with the lowest cost and the most convenient prescription delivery method.