Frequently Asked Questions - Medical
Questions:
Are there useful websites you recommend?
How do I plan ahead for prescription needs for vacation?
How can I or my family obtain confidential help in dealing with personal problems?
How does medical eligibility for student dependents work?
Answers:
Are there useful websites you recommend?
www.medcohealth.com - You can refill or renew prescriptions, view prescription order status, view your pharmacy benefits, find a local pharmacy, print a temporary pharmacy card, research drug information and drug prices. You can also obtain health and wellness information.
Electronic Orange Book - FDA Site that displays generic drugs available for a brand name drug.
www.highmarkbcbs.com - You can obtain cost and quality information by logging into My BlueLink. It also contains Hospital Quality Measures which provide objective, comparable information to evaluate the performance of hospitals.
Nationwide Prescription Assistance Program - This site provides information about patient assistance to receive free or lower cost medications.
www.needymeds.com - This site is designed to provide information about patient assistance programs which provide no cost prescription medications to eligible participants.
www.helpingpatients.org - The Partnership for Prescription Assistance brings together America’s pharmaceutical companies, doctors, patient advocacy organizations and civic groups to help low-income, uninsured patients get free or nearly free brand-name medicines.
www.pfizerhelpfulanswers.com - This site provides one-stop-shopping to help America's uninsured identify and enroll in Pfizer programs that is best for them.
MAPS Advantage Work/Life - This site provides you with a complete collection of web-based information, tools and resources supporting all life cycle and daily living topics. The password is "carpenters" (case-sensitive).
Pennsylvania Department of Public Welfare
PACE and PACENET - offer comprehensive prescription coverage to older Pennsylvanians and cover most medications that require prescriptions, including insulin, syringes and insulin needles.
CHIP(Children's Health Insurance Program) - Pennsylvania's program to provide quality health insurance for children of working families who otherwise could not afford it.
AdultBasic - Covers the basic health care needs of Pennsylvanians age 19-64 who have no health insurance and who meet certain eligibility requirements.
Hill-Burton Program - For individuals who have incurred medical bills that they are unable to pay or who are currently in need of medical services for which they are unable to pay.
How do I plan ahead for prescription needs for vacation?
- Whether you go to a retail pharmacy or use home delivery for your prescriptions, you will need to notify the fund office in advance, of when you are leaving for vacation and how long you plan to be gone. The fund office will be able to give a VACATION OVERRIDE allowing you to have the extra medication you will need providing you have the appropriate number of refills remaining.
- Order vacation refills at least two weeks in advance of your departure. If there is a problem, such as, not enough refills, you will have enough time to phone your physician. If you're using Home Delivery call the fund office for your refill and tell them you are going on vacation at least three weeks in advance.
- Vacation overrides may be obtained once per year. Later refills will not be available until that medication has all been used. For example, on January 1, you got a 90 days supply of medication. In February you decide to go away for four months which would take you through May. You have enough medication for all of February and May. You would call the fund office and ask for a vacation refill (tell them you are going on vacation); that refill will give you enough medication through June 30. You will not be permitted another refill until the end of June.
- Co-payments will be the same as you would normally pay times the number of refills you need.
- If you are already out of town and need a prescription call the fund office. Tell the representative you are out of town and need to find a participating pharmacy in the area where you are. You will need the zip code where you are visiting. In most cases you will have several choices.
How can I or my family obtain confidential help in dealing with personal problems?
A complete explanation of the Membership Assistance Program (MAP) can be found on page 37 in the Medical Plan Handbook.
All members of the The Greater PA Regional Council of Carpenters are eligible to use the Membership Assistance Program (MAP). Your MAP provides you and your family with free and confidential help in dealing with personal problems.
MAP is designed to provide prompt, professional help for you and your eligible dependents experiencing personal problems, such as stress, marital difficulties, child or adolescent concerns, death or illness of a family member, financial pressure, or job stress to name a few. While these are “human problems” that anyone may experience at any time, knowing where to turn for help can be difficult. This membership assistance program operates on a completely confidential basis with you and your eligible dependents. All services provided by this program are strictly confidential, no information can be released without your written permission.
The Greater PA Carpenters Medical Plan has contracted with Lytle EAP Partners to provide Membership Assistance Program Services to you and your family. Lytle EAP Partners is an organization of counselors, social workers, and other professionals who will provide assessment of problems, short-term counseling, and when appropriate, referrals for treatment with clinical specialists who are located near you. Access to Lytle EAP Partners’s providers is excellent. You can contact your Membership Assistance Program directly at (888) MAP-6637 or (888) 627-6637.
You will be eligible to receive up to six (6) visits with a counselor at no cost to you or your eligible dependents. The assessment, short-term counseling and referral services are absolutely free and confidential.
The Trustees believe that this program is a winning situation for everyone. Members and their families have access to a needed valuable benefit and our Employers will have access to a healthier, safer and a more stable workforce. Our Medical Plan will also benefit by providing a program to assist members to resolve personal problems before they develop into conditions that require medical attention.
How does medical eligibility for student dependents work?
Generally, medical coverage for dependents ends on the last day of the month in which the dependent attains age 19. However, coverage can be extended for each unmarried child, age 19 or over, but under age 23, if that child is enrolled as a full-time student in a college (defined as 12+ credits), university, trade school, or is completing high school as a full time student.
IT IS YOUR RESPONSIBILITY TO CONTACT THE FUND OFFICE PRIOR TO THE DEPENDENT'S 19TH BIRTHDAY TO OBTAIN THE NECESSARY INFORMATION IN ORDER TO DOCUMENT ELIGIBILITY. It is also your responsibility to notify our office when the dependent is no longer attending school on a full-time basis.
Please note that once the original documentation process is completed, we will be requesting documentation from you on a semi-annual basis. We will contact you in early August and early December of each year and you will be required to provide us with updated documentation by the end of that month.
Other resources
Blues-On-Call: Your personal Blues On Call nurse Health Coach can help you become more involved and more active in your health care by providing you with up-to-date, easy-to-understand information about medical conditions. Blues On Call Health Coaches are available 24 hours a day, 7 days a week. The health resources you need are as close as a toll-free phone call (1-888-BLUE-428) or your computer.