Network Service
As is indicated in the MILA Medicare Wrap-Around
Chart, most medical and behavioral health service is
available in the MILA Medicare Wrap-Around Plan.
Service is being received through Medicare doctors under
Medicare protocols and not through CIGNA or
ComPsych protocols. There are some exceptions to this:
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First, prescription drugs are secured through
Caremark®’s network of retail and mail pharmacies
just as in the Premier, Basic and Core Plans. The
benefits are the same as in the Premier and
Basic Plans.
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Next, Member Assistance Plan (MAP) service is still
available to all Medicare Wrap-Around Plan Members
through ComPsych.
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Finally, if a medical or behavioral health service is
not covered by Medicare but it is covered under
this Plan (that is, it would have been covered
under the Premier Plan), then that service is covered.
This will not happen often but, if it does, the service
will be available on either of the following terms:
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subject to the Plan’s deductible and coinsurance
as an Out-of-Network expense in an Out-of-Area
plan, or
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as an In-Network service from a CIGNA or
ComPsych provider and subject to the
appropriate Premier Plan copay.
