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

Using the Mail Service

Using the Caremark® Mail Service is easy and convenient. As discussed previously, you must use the Caremark® Mail Service to fill most prescriptions after they have been filled at retail and refilled once. If you refill a prescription at retail after the first refill, it will not be covered by the Plan. the easiest way to begin using the mail service when your physician prescribes a medication which requires more than one refill is to request a second prescription when your physician writes the first one.

The first prescription will be for a 30-day supply of medication and it will allow for one refill. If your physician is certain that the medication prescribed will not have to be adjusted or changed, he/she will give you the second one immediately. Otherwise, he/she will provide it to you after it is certain the prescribed medication is performing as expected.
The second prescription should be for a 90-day supply and it should allow for refills. This second prescription should be sent to Caremark® together with a mail service prescription drug form with your payment.

If you supply Caremark® with your credit or debit card information, it will be easier to pay the cost for this prescription and it will allow you to refill your prescription over the telephone or online at www.caremark.com.

You can get a mail service prescription drug form by calling Caremark®, going to Caremark®’s website or going to MILA’s website and clicking on “Forms” and then “Prescription Form.” Send your completed mail order form(s) along with the associated prescription from your doctor and payment for your copay and any applicable deductibles to:

Caremark®
P.O. Box 3223
Wilkes-Barre, PA 18773-3223

Allow at least five to seven days for your medication to arrive. Many people request a refill when they have a two week supply remaining to ensure that their medication supply does not run out. Your order will be delivered to your mailing address with postage paid in full. It is up to you to request a refill before your current prescription supply runs low to ensure that you can continue to take your medications without interruption.