Common use of Network Pharmacies Clause in Contracts

Network Pharmacies. For Prescription Drugs purchased at a retail or mail order Network Pharmacy, You are responsible for paying the lower of: • The applicable Cost-Sharing; or • The Network Pharmacy’s Usual and Customary Charge (which includes a dispensing fee and sales tax) for the Prescription Drug. (Your Cost-Sharing will never exceed the Usual and Customary Charge of the Prescription Drug.) In the event that Our Network Pharmacies are unable to provide the covered Prescription Drug, and cannot order the Prescription Drug within a reasonable time, You may, with Our prior written approval, go to a Non-Network Pharmacy that is able to provide the Prescription Drug. Contact Us at the number on Your ID card to request approval.