Mail Order Drug Program Clause Samples

Mail Order Drug Program. In addition to the retail pharmacy program, the state shall maintain a mail order drug program for long-term or maintenance medications lasting more than thirty (30) days. The following co-pays for mail order prescriptions of ninety

Mail Order Drug Program. In addition to the retail pharmacy program, the State shall maintain a mail order drug program for long-term or maintenance medications lasting more than thirty (30) days. The following co-pays for mail order prescriptions of ninety (90) days shall apply. For a generic drug, the co-pay is twenty-five dollars ($25.00). For a formulary brand name drug, the co-pay is sixty-two dollars and fifty cents ($62.50), effective July 1, 2018, the co-pay will be seventy five dollars ($75.00), effective July 1, 2019, the co-pay will be eighty seven dollars and fifty cents ($87.50), and effective July 1, 2020 the co-pay will be one hundred dollars ($100.00). For a non-formulary brand name drug, the co-pay is one hundred twenty-five dollars ($125). Where a generic equivalent is available, the co-pay for a non-formulary brand name drug shall be one hundred twenty-five dollars ($125) and the difference in cost between the generic equivalent and the non-formulary brand name drug. Effective July 1, 2018, for a non-formulary brand name drug, the co-pay is one hundred thirty-seven dollars and fifty cents ($137.50). Where a generic equivalent is available, the co-pay for a non-formulary brand name drug shall be one hundred thirty-seven dollars and fifty cents ($137.50) and the difference in cost between the generic equivalent and the non-formulary brand name drug. Effective July 1, 2019, for a non-formulary brand name drug, the co-pay is one hundred and fifty dollars ($150.00). Where a generic equivalent is available, the co-pay for a non-formulary brand name drug shall be one hundred and fifty dollars ($150.00) and the difference in cost between the generic equivalent and the non-formulary brand name drug. Effective July 1, 2020, for a non-formulary brand name drug, the co-pay is one hundred and eighty seven dollars and fifty cents ($187.50). Where a generic equivalent is available, the co-pay for a non-formulary brand name drug shall be one hundred and eighty seven dollars and fifty cents ($187.50) and the difference in cost between the generic equivalent and the non-formulary brand name drug. Generic medication classifications will be determined by the PBM based on industry standards in which the PBM utilizes an independent third party data service for new and existing drug product pricing, coding, and classification information.

Mail Order Drug Program. In addition to the retail pharmacy program, the State shall maintain a mail order drug program for long-term or maintenance medications lasting more than thirty (30) days. The following copays for mail order prescriptions of ninety (90) days shall apply. For a generic drug, the copay is twenty-five dollars ($25.00). For a formulary brand name drug, the copay is one hundred dollars ($100.00). For a non-formulary brand name drug, the copay is one hundred and eighty-seven dollars and fifty cents ($187.50). Where a generic equivalent is available, the copay for a non-formulary brand name drug shall be one hundred and eighty-seven dollars and fifty cents ($187.50) and the difference in cost between the generic equivalent and the non-formulary brand name drug. Generic medication classifications will be determined by the PBM based on industry standards in which the PBM utilizes an independent third-party data service for new and existing drug product pricing, coding, and classification information.