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 Prescription Drugs

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

MILA/CVS Caremark Maintenance Choice Program

Regular Mail Order Service or Maintenance Choice

When You Must Use the Mail Service

Exceptions to Mandatory Mail Service

Paying for Your Prescription Drugs through the Mail Service Pharmacy

Covered Prescription Drugs

Specialty Medications

Quantity Restrictions on Covered Medications

When to Get Prior Approval for a Prescription

When Covered by More than One Prescription Drug Plan

The MILA Dental Plan

The MILA Vision Plan


	What is Not Covered


	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 CVS Caremark retail network of participating pharmacies for up to a 30-day supply;
Any other retail pharmacy that is not part of the CVS Caremark retail pharmacy network for up to a 30-day supply;
At CVS retail pharmacies using the Maintenance Choice Program for up to a 90-day supply; or
Through the CVS Caremark Mail Service Pharmacy for up to a 90-day supply.

Note

Generally, you may refill a prescription through a retail pharmacy only once. After that, you must use the CVS Caremark Mail Service Pharmacy or the Maintenance Choice Program in order for the Plan to cover your prescription. These programs generally provide you with the lowest cost and the most convenient prescription delivery method.