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FAQ/Prescriptions

Prescriptions

1. How do I file a claim?

If you participate in the MILA Pharmacy program, you can go to any Caremark participating pharmacy. (Most of the Major chains). A listing was sent to you along with your prescription cards. Customer Service can also give you the name of a nearby participating pharmacy. The phone number 1-866-875-MILA can be found on the back of your card. Present your prescription, show your Caremark ID card and pay a small co-payment (view co-payment levels for the Premier, Basic, or Core plans). No paperwork or claim forms are necessary if you use a participating pharmacy. Please note that ALL MAINTENANCE DRUGS including injectibles must go through the Caremark Mail Order Service (copies of mail order forms were mailed to you in the packet with your cards).

2. I take maintenance medication. Is there any way to eliminate my monthly trips to the pharmacy?

Absolutely. If you are a Caremark Mail Service program participant, you are also eligible to participate in our mail-order program; you never have to go to the pharmacy for your maintenance medication again. We will mail you up to a 90-day supply of your medication. (Information was sent along with your prescription cards)

3. What do I do if I want to have my refills filled at a different participating pharmacy within your network?

The laws for transferring a prescription from one pharmacy to another are governed by each state, and can vary from one state to another. However, for the most part, transferring a valid prescription from one MILA Caremark participating pharmacy to another is relatively easy. Call or visit the new pharmacy and ask the pharmacist to arrange to have the prescription transferred. It's that simple. Your new pharmacist will contact the prior pharmacy and take down pertinent information to complete the transfer.

In most states, "controlled substances" such as narcotics have limitations on transferability. Under the MILA pharmacy program, such medications can be obtained at the local pharmacy - NOT THROUGH MAIL ORDER.

4. What are the differences between brand-name drugs and generic drugs?

You probably know that pharmaceutical companies carry out extensive research and clinical testing to win approval from the Food and Drug Administration for new drugs. The new drug is then protected by patent for at least 10 years. This patented drug is called a brand name drug. When the patent expires, another drug company can "copy the recipe" for the brand drug. This "copy" is called a generic drug. The FDA requires that generic drugs have the same active chemical composition, be dispensed in the same dosage form such as a tablet or capsule and be taken in the same dosage as the brand-name drug.

Generic drugs usually cost less and competitive pricing by the different manufacturers further reduces the prices. Occasionally, generic drugs may look different from their brand-name versions because the inactive ingredients such as fillers and dyes can be different. However, these ingredients do not affect the safety or performance (efficacy) of the drug.

5. What is a covered prescription drug?

The term prescription drug includes drugs prescribed for the treatment of an injury or sickness. These drugs are dispensed upon the written prescription of a physician or other lawful provider. It may include oral and injectable insulin dispensed only upon the written prescription of a physician. It also includes needles and syringes.

6. What is a formulary?

A drug formulary is a complete list of preferred medications covered by your MILA prescription drug plan. This comprehensive listing includes most brand name and appropriate generic equivalents for leading medications. The formulary has been compiled after a significant investigation and intensive evaluation process identified drugs which are used most frequently by the MILA Membership.

7. Co-payments: How to determine what you pay for prescription drugs?

A co-payment is the predetermined fee you pay for covered health care benefits -- in this case, prescription drugs. Co-payment amounts are set by the health plan. To determine your co-payment level, please refer to the following: Premier, Basic, or Core plans.

8. Why there are different co-payments for different drugs?

The cost of drugs varies widely, and several different medications may be used to treat the same condition. Generic drugs offer the most savings and therefore have the lowest co-payment. Brand-name drugs cost more and therefore have a higher co-payment.