Medical FAQ

Are there useful websites you recommend?

www.express-scripts.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.

www.needymeds.org – This site is designed to provide information about patient assistance programs which provide no cost prescription medications to eligible participants.

www.pparx.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.phahelps.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.

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.

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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.

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How can I or my family obtain confidential help in dealing with personal problems?

All members of the Keystone Mountain Lakes 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.

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.

Understanding Medicare Drug Coverage

Refer to this link, which explains how the Medical Drug Coverage works, summarizes standard Medicare Prescription Drug Coverage and other resources for more information.

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What is Third Party Sick Pay?

Active members who are eligible in the Greater Pennsylvania Carpenters’ Medical Plan are eligible for weekly disability benefits (sick pay).  The weekly disability benefit will be payable to the member if, while covered by the Plan, becomes disabled and unable to work because of a con-occupational accident or illness.

Contact the Medical Department of Carpenter’s Combined Funds at 412-922-5330 for further details on how to qualify for the benefit.

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