Q. How can I get a mail order form for Express Scripts mail order service?
A. If you take long-term, maintenance medications, you can save money by ordering them through Medco’s mail order service, Express Scripts 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 Express Scripts OR you can mail your prescription along with a Express Scripts by Mail form. To obtain a mail order form, call Express Scripts toll-free Member Services hotline at 1-800-711-0917 or go to www.express-scripts.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 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.
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:
Through VSP – Through VSP, you have access to comprehensive eye care, including exams, glasses, contact lenses, etc.
Through the Plan’s major medical coverage – Routine eye care is now covered through VSP, but the Plan continues to cover refractive eye surgery (LASIK). After you pay the Plan’s annual deductible, the Plan will pay 90%/70% to $1,500 per eye up, $3,000 (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. No. The Patient Protection and Affordable Care Act extended coverage to all children up to age 26. There are no requirements for student status or marital status. The only requirement is that the adult dependent not be eligible for employmer based coverage through their own or a spouse's employer.
Q. Is well-child coverage available under the 1014 Health and Welfare Plan?
A.Yes. The Plan pays for well-baby care for the child's first two years. In addition all participants have a wellness benefit to cover routine exams, immunizations and screenings.
Q. Do I need a referral if I want to go to an acupuncturist ?
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. You may self-refer to any physician, licensed acupuncturist, or doctor of oriental medicine, and you do not need a physician's prescription for acupuncture (the Plan allows up to 30 total visits per calendar year).
Q.Do I need a referral if I want to go to a physical therapist?
A. Physical Therapy must be prescribed by a physician. The Plan pays for covered physical therapy expenses up to 30 visits per calendar year when performed by a physician, registered physical therapist, or occupational therapist.
Local 1014 Medical Plan
3460 Fletcher Avenue
El Monte, CA 91731 800-660-1014