Generic Drugs. The Health Insurance Exchange Metal Level Formulary covers both brand-name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient and may be substituted for the brand-name drug. Generally, generic drugs cost less than brand-name drugs.
Generic Drugs. If under this Agreement the Grantee prescribes or dispenses drugs to consumers, it shall do so in accordance with Act 259 of November 24, 1976, P.L. 1163, 35 P.S. §960.1 et seq., as amended, and prescribe and dispense generically equivalent drugs rather than brand name drugs whenever possible.
Generic Drugs. Drugs that (1) are approved by the Food and Drug Administration (FDA) as a therapeutic equivalent to the Brand Name Drug, (2) contain the same active ingredient as the Brand Name Drug, and (3) cost less than the Formulary Brand Name Drug equivalent. Home Self-Administered Injectables - Home Self- Administered Injectable medications are defined as those Drugs that are Medically Necessary; administered more often than once a month by the patient or family mem- ber; administered subcutaneously or intramuscularly; deemed safe for self-administration as determined by Blue Shield of California’s Pharmacy and Therapeutics Committee; prior authorized by Blue Shield of Califor- nia; and obtained from a Blue Shield of California Spe- cialty Pharmacy. Intravenous (IV) medications (i.e. those medications administered directly into a vein) are not considered Home Self-Administered Injectable drugs. Home Self-Administered Injectables are listed in Blue Shield’s Drug Formulary. Non-Formulary Drugs — Drugs determined by the Blue Shield Pharmacy and Therapeutics Committee as being duplicative or as having preferred Formulary Drugs alternatives available. Benefits are provided for Non-Formulary Drugs and are always subject to the Non-Formulary Copayment. Non-Participating Pharmacy — a pharmacy which does not participate in the Blue Shield of California Pharmacy Network. Participating Pharmacy — a pharmacy that participates in the Blue Shield Pharmacy Network. These Participat- ing Pharmacies have agreed to a contracted rate for cov- ered prescriptions for Blue Shield Subscribers and De- pendents. To select a Participating Pharmacy, the Subscriber may access this information at xxxx://xxx.xxxxxxxxxxxx.xxx or call the toll-free Member Services telephone number on their Blue Shield of California Identification Card. Specialty Pharmacy Network – select Participating Pharmacies contracted by Blue Shield of California to provide covered Home Self-Administered Injectables. These pharmacies offer 24-hour clinical services and provide prompt home delivery of Home Self- Administered Injectables. To select a Specialty Pharmacy, the Subscriber may ac- cess this information at xxxx://xxx.xxxxxxxxxxxx.xxx or call the toll-free Member Services telephone number on their Blue Shield of California Identification Card.
Generic Drugs. The Health Insurance Exchange Metal Level Formulary covers both brand-name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient and may be substituted for the brand-name drug. Generally, generic drugs cost less than brand-name drugs. Brand Name drugs when a generic Equivalent is Available A generic equivalent will be dispensed if available. If your prescriber requests to dispense a brand-name drug when a generic equivalent is available, the request will require a Medical Exception. If Medical necessity is established the non-preferred drug copay plus the difference between the brand-name and the generic drug will apply. Otherwise, brand-name drugs dispensed when a generic equivalent is available are not covered and will not count towards the deductible or annual out-of-pocket maximums.
Generic Drugs. Drugs that (1) are approved by the Food and Drug Administration (FDA) as a therapeutic and equivalent to the Brand Name Drug, (2) contain the same active ingredient as the Brand Name Drug, and (3) cost less than the Formulary Brand Name Drug equiva- lent.
Generic Drugs. If under this Agreement the Contractor prescribes or dispenses drugs to consumers, it shall do so in accordance with Act 259 of November 24, 1976, P.L. 1163, 35 P.S. §960.1 et seq., as amended, and prescribe and dispense generically equivalent drugs rather than brand name drugs whenever possible.
Generic Drugs. Drugs that (1) are approved by the Food and Drug Administration (FDA) or other authorized government agency as a therapeutic equivalent or authorized generic to the Brand Drug, (2) contain the same active ingredient as the Brand Drug, and (3) typically cost less than the Brand Name Drug equivalent. Habilitation Services – Medically Necessary services and health care devices that assist an individual in partially or fully acquiring or improving skills and functioning and that are necessary to address a health care condition, to the maximum extent practical. These services address the skills and abilities needed for functioning in interaction with an individual’s environment. Respite care, day care, recreational care, Residential Care, social services, Custodial Care, or education services of any kind are not considered Habilitative Services.
Generic Drugs. Formulary Three: Drugs purchased on the prescription of a medical doctor or dentist, which a pharmacist would not normally dispense without a prescription, including oral contraceptives, injected allergy sera and insulin, needles, syringes and test-tape for use by diabetics. Smoking cessation aids, both prescribed and over the counter, are limited to $300 per person per calendar year. Benefits are not payable for vitamins or vitamin preparations or drugs not approved for legal sale to the general public in Canada. The name, strength and quantity of the drug must be shown on all receipts. In any event, the amount payable for all eligible drugs and medicines for which an interchangeable generic equivalent is available will be limited to the lower of the actual cost or the lowest cost generic equivalent.
Generic Drugs. Effective October 1, 1996 the Plan shall provide that unless otherwise specified by the prescribing physician, the pharmacy will be required to dispense a generic drug whenever a generic substitution is available.
Generic Drugs. Prescription Drugs that are not Brand Name Drugs but which are made up of equivalent ingredients. Health Insurance Marketplace Known as the Health Insurance Marketplace. A marketplace that allows individuals and small businesses to shop for coverage in a way that permits comparison of available plan options and to find out if they are eligible for tax credits and/or cost-sharing reductions. Home Health Care Care, by a state-licensed program or Provider, for the treatment of a patient in the patient’s home, consisting of required intermittent skilled care, which may include observation, evaluation, teaching and nursing services consistent with the diagnosis, established and approved in writing by the patient’s attending Physician.
