Questions & Answers

 

Q.    How can I get a mail order form for Medco’s mail order service?

A.    If you take long-term, maintenance medications, you can save money by ordering them through Medco’s mail order service, Medco by Mail. To take advantage of this cost-saving feature, ask your doctor to fax your prescription (typically for a 60- or 90-day supply) to Medco OR you can mail your prescription along with a Medco by Mail form. To obtain a mail order form, call Medco’s toll-free Member Services hotline at 1-800-711-0917 or go to www.medco.com. You can also download a copy of the form from the Local 1014 Health and Welfare Plan CD. When you receive your prescription, there will be extra order forms included in the packet.

 

Q.    Are sports physicals for children covered?

A.    Although the Plan does not cover sports physicals per se, it does cover charges for wellness care up to $250 per calendar year for screening X-rays, preventive lab tests, and examinations other than those covered under preventive cancer examinations. No diagnosis is required, the deductible does not apply, and there are no copays. If you want your child’s sports physical to be covered under the wellness benefit provision, you MUST notify the Plan in advance, or the physical will not be covered.

 

Q.    I’m confused about our vision coverage. What type of coverage do we have?

A.    The Local 1014 Health and Welfare Plan offers TWO great ways to get vision-related benefits:

1. Through VSP – Through VSP, you have access to comprehensive eye care, including exams, glasses, contact lenses, etc.
2. Through the Plan’s major medical coverage – Routine eye care is now covered through VSP, but the Plan continues to cover refractive eye survey LASIK). After you pay the Plan’s annual deductible, the Plan will pay 50% per eye up to $1,000 per eye (per lifetime).

 

Q.    My 19-year old son is starting college this year. I heard that he might need to have a special form filled out by the college to keep him covered under the Plan. Is this true?

A.    Yes. When he registers for school (he must be carrying at least 12 units), have him take a Student Verification Form with him. The school should fill out the form. Your son should send the completed form back to the Local 1014 Health and Welfare Plan Insurance Office. You can download a copy of this form from our web site (www.local1014medical.org) or from your SPD CD-ROM.

 

Q.    Is well-child coverage available under the 1014 Health and Welfare Plan?

A.    Yes. The Plan pays for covered expenses incurred for well child office examinations and immunizations (not incidental to treatment of illness or injury) before the child’s twelfth birthday, including hepatitis B immunizations for children of any age, up to $2,000 per lifetime.

 

Q.    Do I need a referral if I want to go to an acupuncturist or a physical therapist?

A.    No. Under the Local 1014 Health and Welfare Plan, you have freedom of choice! This is one of the advantages of being covered under our Plan.

Acupuncture benefit -  If you have a prescription from a licensed physician, you may self-refer to any physician or licensed acupuncturist (the Plan allows up to $50 per visit; 12 visits per 12-month period).

Physical therapy benefit - The Plan pays for covered physical therapy expenses when prescribed by a physician and performed by a physician, registered physical therapist, or occupational therapist. The table below shows the schedule of benefits (which may be changed if medically necessary).