Common use of NON-NETWORK Clause in Contracts

NON-NETWORK. If a member chooses to use a non-network pharmacy, s/he will be required to pay the full cost of the prescrip- tion and then file a claim with the PBM. The PBM will reimburse the cost of the drug based on the network discounted amount as determined by the PBM, less the applicable copayment.

Appears in 1 contract

Sources: Health Care Plan Rules

NON-NETWORK. If a member chooses to use a non-network pharmacy, s/he will be required to pay the full cost of the prescrip- tion and then file a claim with the PBM. The PBM will reimburse the cost of the drug based on the network discounted amount as determined by the PBM, less the applicable copaymentdeductible or coinsurance.

Appears in 1 contract

Sources: Health Care Plan Rules

NON-NETWORK. If a member chooses to use a non-network pharmacy, s/he will be required to pay the full cost of the prescrip- tion and then file a claim with the PBM. The PBM will reimburse the cost of the drug based on the network discounted amount as determined by the PBMpharmacy benefit manager, less the applicable copaymentdeductible or coinsurance.

Appears in 1 contract

Sources: Health Care Plan Rules