MILA : WHAT IS COVERED

	Benefits Summary


	What Is Covered

Explanation of Terms

Medically Necessary Care

Reasonable and Customary Charges

Approving Your Care

If you do not get Approved

Approval if you have Other Coverage

Finding and In-Network Provider

Your Medical Id Care

Covered Medical Services

Other Medical Services

Non-Routine Care and Services

What is Covered Under the Behavioral Health Program

The Prescription Drug Program

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

Your Medical ID Card

You should present your CIGNA/ComPsych ID card each time you visit a doctor or other medical provider, or when you go to the hospital. Your ID card shows the Plan name and the group number, as well as CIGNA/ComPsych’s toll-free numbers for Member Services. You should keep this card with you at all times.

You should present your Caremark® ID card at the pharmacy each time you want to ﬁll or reﬁll a prescription. If you do not show the pharmacist your Caremark® ID card, then he/she cannot properly process your prescription as a network expense and your prescription may be processed as Out-of-Network.

If you lose or damage your ID card, call MILA immediately to request a replacement. If you have an emergency and don’t have your card with you, either have a family member or friend bring it to the emergency room as soon as possible or call your local Port Administrator or MILA.