Common use of Copayments and annual out-of-pocket maximums Clause in Contracts

Copayments and annual out-of-pocket maximums. For the first and second year of the contract: Tier 1 copayment: Fourteen dollar ($14) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five dollar ($25) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty dollar ($50) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of pocket maximum: There is an annual maximum eligible out-of-pocket expense limit for prescription drugs of eight hundred dollars ($800) per person or one thousand six hundred dollars ($1,600) per family.

Copayments and annual out-of-pocket maximums. For the first and second each year of the contract: Tier 1 copayment: Fourteen Ten dollar ($1410) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five Sixteen dollar ($2516) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty Thirty-six dollar ($5036) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of Out-of-pocket maximum: There is an annual maximum eligible out-of-pocket expense limit for prescription drugs of eight hundred dollars ($800) per person or one thousand six hundred dollars ($1,600) per family.

Copayments and annual out-of-pocket maximums. For the first and second year of the contract: Tier 1 copayment: Fourteen Twelve dollar ($1412) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five Eighteen dollar ($2518) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty Thirty-eight dollar ($5038) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of pocket maximum: There is an annual maximum eligible out-of-pocket expense limit for prescription drugs of eight hundred dollars ($800) per person or one thousand six hundred dollars ($1,600) per family.

Copayments and annual out-of-pocket maximums. For the first and second year of the contract: Tier 1 copayment: Fourteen dollar Eighteen dollars ($1418) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five dollar Thirty dollars ($2530) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty dollar Fifty-five dollars ($5055) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of pocket maximum: There is an annual maximum eligible out-of-pocket expense limit for prescription drugs of eight one thousand and fifty dollars ($1,050) per person or two thousand one hundred dollars ($800) per person or one thousand six hundred dollars ($1,6002,100) per family.

Copayments and annual out-of-pocket maximums. For the first and second year of the contract: Tier 1 copayment: Fourteen dollar Eighteen dollars ($1418) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five dollar Thirty dollars ($2530) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty dollar Fifty-five dollars ($5055) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of pocket maximum: There is an annual maximum eligible out-of-pocket expense limit for prescription drugs of eight one thousand fifty dollars ($1,050) per person or two thousand one hundred dollars ($800) per person or one thousand six hundred dollars ($1,6002,100) per family.

Copayments and annual out-of-pocket maximums. For the first and second year of the contract: Tier 1 copayment: Fourteen Eighteen dollar ($1418) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five Thirty dollar ($2530) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty Fifty-five dollar ($5055) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of pocket maximum: There is an annual maximum eligible out-of-pocket expense limit for prescription drugs of eight one thousand fifty dollars ($1050) per person or two thousand one hundred dollars ($800) per person or one thousand six hundred dollars ($1,6002,100) per family.

Copayments and annual out-of-pocket maximums. For the first and second year of the contract: Tier 1 copayment: Fourteen Eighteen dollar ($1418) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five Thirty dollar ($2530) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty Fifty-five dollar ($5055) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of pocket maximum: There is an annual maximum eligible out-of-pocket expense limit for prescription drugs of eight one thousand and fifty dollars ($1,050) per person or two thousand one hundred dollars ($800) per person or one thousand six hundred dollars ($1,6002,100) per family.

Copayments and annual out-of-pocket maximums. For the first and second year of the contract: Tier 1 copayment: Fourteen Eighteen-dollar ($1418) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: TwentyThirty-five dollar ($2530) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty Fifty-five-dollar ($5055) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of pocket maximum: There is an annual maximum eligible out-of-pocket expense limit for prescription drugs of eight one thousand fifty dollars ($1,050) per person or two thousand one hundred dollars ($800) per person or one thousand six hundred dollars ($1,6002,100) per family.

Copayments and annual out-of-pocket maximums. For the first and second each year of the contract: Tier 1 copayment: Fourteen Ten dollar ($1410) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five Sixteen dollar ($2516) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty Thirty-six dollar ($5036) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of Out-of-pocket maximum: There is an annual maximum eligible out-of-of- pocket expense limit for prescription drugs of eight hundred dollars ($800) per person or one thousand six hundred dollars ($1,600) per family.

Copayments and annual out-of-pocket maximums. For the first and second year of the contract: Tier 1 copayment: Fourteen dollar Eighteen dollars ($1418) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five dollar Thirty dollars ($2530) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty dollar Fifty‐five dollars ($5055) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of pocket maximum: There is an annual maximum eligible out-of-pocket out‐of‐pocket expense limit for prescription drugs of eight one thousand fifty dollars ($1,050) per person or two thousand one hundred dollars ($800) per person or one thousand six hundred dollars ($1,6002,100) per family.

Copayments and annual out-of-pocket maximums. For the first and second each year of the contract: Tier 1 copayment: Fourteen Ten dollar ($1410) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five Sixteen dollar ($2516) copayment per Per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty Thirty-Six dollar ($5036) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of Out-of-pocket maximum: There is an annual maximum eligible out-out of-pocket expense limit for prescription drugs of eight hundred dollars ($800) per person or one thousand six hundred dollars ($1,600) per family.

Copayments and annual out-of-pocket maximums. For the first and second year of the contract: Tier 1 copayment: Fourteen dollar ($14) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Twenty-five dollar ($25) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Fifty dollar ($50) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out of pocket maximum: There is an annual maximum eligible out-of-of- pocket expense limit for prescription drugs of eight hundred dollars ($800) per person or one thousand six hundred dollars ($1,600) per family.