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Charges Not Covered in the Prescription Drug Program

Listed below are medications the MILA National Health Plan does not cover under the Prescription Drug Program:

  • Drugs that do not require prescriptions, such as over-the-counter remedies, or for which there is a generic equivalent drug that is available in non-prescription form;
  • Drugs for the treatment of pain (delivered as patches, lotions or creams), the active ingredients of which are sold over the counter but one or more of the active ingredients are in an increased concentration;
  • Compound prescriptions that do not have at least one ingredient that is a legend drug requiring a prescription under federal or state law or for which you have not received prior authorization from the Claims Administrator pursuant to the Plan’s requirements;
  • Drugs not included in the MILA/CVS Caremark Prescription Drug Formulary;
  • Drugs that are covered under another part of the MILA National Health Plan or that are limited or excluded because they are experimental, investigational or not medically necessary;
  • Drugs that are covered under Workers’ Compensation or any government program (state, federal or municipal) that does not claim secondary payer status;
  • Drugs or devices for cosmetic purposes, hair growth, smoking cessation, anti-obesity, weight control, and contraception except for oral contraceptives and the specific products Nuva-Ring and Ortho Evra;
  • Drugs not approved by the U.S. Food and Drug Administration (FDA) or not approved by the FDA for the condition, dose, routine and frequency for which they are being prescribed;
  • Drugs provided at no charge to you or for which you would not have to pay in the absence of this or similar coverage;
  • Drugs required as a result of an act of war, declared or undeclared;
  • Food, diet and nutritional supplements except prescription vitamins and minerals; and
  • Natural remedies (naturopathic) and homeopathic services, substances and supplies.


If you have questions about the Prescription Drug Program or to determine if a particular medication is covered, you can call CVS Caremark directly at 1-866-875-MILA (6452).