For Active Employees

Can I choose to continue medical but drop my other health care benefits?

No, your health care benefits are treated as a package. You may either continue all of the health care benefits you had at the time of the qualifying event or choose to let all such benefits end.
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Prescription Drug Benefits

Plan Administrator

Procare Rx

Plan Benefits

The Los Angeles Machinist Benefit Trust offers the following prescription drug plans options. If you are enrolled in a PPO, refer to your Schedule of Benefits to see which plan option is available to you. If you enroll in an HMO, your prescription benefits will be provided under the HMO.

Prescription Drug Plan Options

 

  High Plan Medium Plan Low Plan
Walk-In Pharmacies
  • 30-day supply
  • Generic drug: $2 copay
  • Brand-name drug: $2 copay. Brand-name drugs are only covered when medically indicated or when a generic is unavailable.
  • 30-day supply
  • Generic drug: $10 copay
  • Brand-name drug: $30 copay. Brand-name drugs are only covered when medically indicated or when a generic is unavailable.
  • 30-day supply
  • Generic drug: $10 copay
  • Brand-name drug: $30 copay. Brand-name drugs are only covered when medically indicated or when a generic is unavailable.
Mail-Order Service:
  • 60-day supply
  • Generic drug: $2 copay
  • Brand-name drug: $2 copay. Brand-name drugs are only covered when medically indicated or when a generic is unavailable.
  • Use of the mail-order service is not mandatory.
  • 60-day supply
  • 2x retail copay
  • Use of the mail-order service is mandatory.
  • 60-day supply
  • 2x retail copay
  • Brand-name drugs are only covered when medically indicated or when a generic is unavailable.
  • Use of the mail-order service is mandatory.

To Locate Participating Pharmacies and Mail Order Facility

Call the Procare Rx Customer Service Center at 1-(855) 828-1484 to find the pharmacy nearest you.

What the Plan Covers

The prescription drug plan covers:

  • All Federal Legend drugs, including new drugs approved by the FDA;
  • Insulin, insulin syringes and needles, and certain diabetic supplies;
  • Compound medications, if at least one ingredient requires the Federal Legend; and
  • Smoking deterrents—up to a maximum benefit of $100 per person per lifetime.

Refer to your Summary Plan Description for complete details on Plan coverage, limits, and exclusions.

Filing a Claim

You do not need to file a claim for prescription drug benefits. You pay the applicable copay each time you fill or refill a prescription and the Plan pays the remainder of the cost.