Covered Prescription Drugs Sample Clauses

Covered Prescription Drugs. FDA approved formulary prescription drugs. Federal law requires a prescription for these drugs. They are known as “legend drugs.” • Compound drugs when the main drug ingredient is a covered prescription drug • Oral drugs for controlling blood sugar levels, insulin and insulin pens • Throw-away diabetic test supplies such as test strips, testing agents and lancets • Drugs for shots you give yourself • Needles, syringes and alcohol swabs you use for shots • Glucagon emergency kits • Inhalers, supplies and peak flow meters • Drugs for nicotine dependency. Generic over the counter (OTC) also covered. • Human growth hormone drugs when medically necessary
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Covered Prescription Drugs.  FDA approved formulary prescription drugs. Federal law requires a prescription for these drugs. They are known as “legend drugs.”  Compound drugs when the main drug ingredient is a covered prescription drugOral drugs for controlling blood sugar levels, insulin and insulin pens  Throw-away diabetic test supplies such as test strips, testing agents and lancets  Drugs for shots you give yourself  Needles, syringes and alcohol swabs you use for shots  Glucagon emergency kits  Inhalers, supplies and peak flow meters  Drugs for nicotine dependency. Generic over the counter (OTC) also covered.  Human growth hormone drugs when medically necessary  All FDA approved oral contraceptive drugs and devices such as diaphragms and cervical caps are covered in full when provided by an in-network pharmacy, see Preventive Drugs in the Summary of Your CostsOral chemotherapy drugs  Drugs associated with an emergency medical condition (including drugs from a foreign country)
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Covered Prescription Drugs. The prescription drugs covered by this Section V.K.5. are:
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Covered Prescription Drugs. We cover Medically Necessary Prescription Drugs that, except as specifically provided otherwise, can be dispensed only pursuant to a prescription and are: • Not Experimental/Investigative; • Determined by Us to be appropriate in quantity; • Determined by Us to be appropriate for Your age; • Required by law to bear the legend “Caution – Federal Law prohibits dispensing without a prescription”; • FDA approved; • Ordered by a Provider authorized to prescribe and within the Provider’s scope of practice; • Prescribed within the approved FDA administration and dosing guidelines; and • Dispensed by a licensed, Network Pharmacy. • Covered Prescription Drugs Benefits include but are not limited to the following: • Prescription Legend Drugs • Specialty Drugs • Injectable insulin and syringes used for administration of insulin. • Oral contraceptive Drugs, injectable contraceptive drugs and patches are covered when obtained through an eligible Pharmacy. Certain contraceptives are covered under the “Preventive Care” benefit. Please see that section for further details. • Injectables • Off label use, unless approved by Us or the PBM or when the drug has been recognized as safe and effective for treatment of that indication in one or more of the standard medical reference compendia adopted by the United States Department of Health and Human Services or in medical literature that meets certain criteria. Medical literature may be accepted only if all of the following apply:
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Related to Covered Prescription Drugs

  • Prescription Drugs The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types of treatments limit is preauthorization. Preauthorization is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. Mental disorders are covered under Section A. Mental Health Services. Substance use disorders are covered under Section

  • Prescription Drug Plan Effective January 1, 2022, retail and mail order prescription drug copays for bargaining unit employees shall be as follows: Type of Drug Prescriptions for 1-45 Days (1 copay) Prescriptions for 46-90 Days (2 copays) Generic drug $10 $20 Preferred brand name drug $25 $50 Non- referred brand name drug $40 $80 Effective January 1, 2022, for each plan year the Prescription Drug annual out-of-pocket copay maximum shall be $1,000 for individual coverage and $1,500 for employee and spouse, employee and child, or employee and family coverage.

  • Prescription Glasses This plan covers prescription glasses as follows: • Frames - one (1) collection frame per plan year; • Lenses - one (1) pair of glass or plastic collection lenses per plan year. This includes single vision, bifocal, trifocal, lenticular, and standard progressive lenses. This plan covers the following lens treatments: • UV treatment; • tint (fashion, gradient, and glass-grey); • standard plastic scratch coating; • standard polycarbonate; and • photocromatic/transitions plastic. Contact Lenses (in lieu of prescription glasses) This plan covers one (1) supply of contact lenses as follows: • conventional contact lenses - one (1) pair per plan year from a selection of provider designated contact lenses; or • extended wear disposable lenses - up to a 6-month supply of monthly or two- week single vision spherical or toric disposable contact lenses per plan year; or • daily wear disposable lenses - up to a 3-month supply of daily single vision spherical disposable contact lenses per plan year. This plan also covers the evaluation, fitting, or follow-up care related to contact lenses. This plan covers additional contact lenses if your prescribing network provider submits a verification form, with the regular claim form, verifying that you have one of the following conditions: • anisometropia of 3D in meridian powers; • high ametropia exceeding -10D or +10D in meridian powers; • keratoconus when the member’s vision is not correctable to 20/25 in either or both eyes using standard spectacle lenses; and • vision improvement for members whose vision can be corrected two lines of improvement on the visual acuity chart when compared to the best corrected standard spectacle lenses.

  • Prescription Claims against the Issuer or any Guarantor for the payment of principal or Additional Amounts, if any, on the Notes will be prescribed ten years after the applicable due date for payment thereof. Claims against the Issuer or any Guarantor for the payment of interest on the Notes will be prescribed five years after the applicable due date for payment of interest.

  • Prescription Safety Glasses Prescription safety glasses will be furnished by the employer. The employer retains the authority to establish reasonable rules and procedures regarding frequency of issue, replacement of damaged glasses, limits on reimbursement costs and coordination with the employer's vision plan.

  • Random Drug Testing All employees covered by this Agreement shall be subject to random drug testing in accordance with Appendix D.

  • DRUG/ALCOHOL TESTING 8.1 The parties agree that the maintenance of a drug/alcohol free work place is a goal of both the College and the Union. Employees are prohibited from possession, consumption and/or being under the influence of a controlled substance/alcohol while on the College’s premises or during time paid by the employer. Violations of this prohibition may result in a disciplinary action up to and including termination.

  • Substance Abuse Program The SFMTA General Manager or designee will manage all aspects of the FTA-mandated Substance Abuse Program. He/she shall have appointing and removal authority over all personnel working for the Substance Abuse Program personnel, and shall be responsible for the supervision of the SAP.

  • Drug Testing (A) The state and the PBA agree to drug testing of employees in accordance with section 112.0455, F.S., the Drug-Free Workplace Act.

  • Prescription Plan The PPO plan will include a comprehensive prescription 37 program: 38

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