Common use of How Copayment Amounts Apply Clause in Contracts

How Copayment Amounts Apply. If the Allowable Amount of the Drug is less than the Copayment, You pay the lower cost. You will pay no more than the applicable Preferred Brand Name Drug or Non- Preferred Brand Name Drug Copayment if the prescription has no generic equivalent. If You receive a Brand Name Drug when a generic equivalent is available, the Copayment will be the total of the Generic Drug Copayment plus the difference between the cost of the Generic Drug equivalent and the cost of the Brand Name Drug. Drug Coupons, Rebates and Other Discounts. Drug manufacturers may offer drug coupons, rebates or other drug discounts to Members, which may impact the benefits provided under this Certificate. The total benefits payable will not exceed the balance of the Allowable Amount remaining after all drug coupons, rebates or other drug discounts have been applied. The Member agrees to reimburse HMO any excess amounts for benefits we have paid You and for which You are not eligible due to the application of drug coupons, rebates or other drug discounts. About Your Benefits

Appears in 4 contracts

Sources: Health Care Benefits Program, Certificate of Coverage, Certificate of Coverage