Month Dispensing Clause Samples

Month Dispensing. You are entitled to receive a six-month supply of contraceptives, if prescribed and self- administered, when dispensed at one time by your pharmacy. To receive this benefit, your Provider must specifically prescribe the six-month supply. If you need to change your contraceptive method before the six-month supply runs out, you may do so without Cost Sharing. You will not owe Cost Sharing for any related contraceptive counseling or side-effects management. Your plan may exclude or apply cost sharing to a name-brand contraceptive if a generic or therapeutic equivalent is available within the same category of contraception. Refer to the table list of contraceptive categories above. Ask your Provider about a possible equivalent. If your Provider determines that a brand-name contraceptive is medically necessary, your Provider may ask us to cover that contraceptive without Cost Sharing. If we deny the request, you or your Provider can submit a grievance to contest that denial. This plan covers vasectomies and male condoms. Your plan covers male condoms with no Cost Sharing, after the deductible is met, and a Prescription is not required. Please see the section below on Coverage for Contraception Where a Prescription Is Not Required for instructions on reimbursement for condoms. Your plan covers contraception methods that are prescribed for the prevention of sexually transmitted infections (STIs). No Cost Sharing applies.