Common use of Prescription Drug Program Clause in Contracts

Prescription Drug Program. Non-Network If a covered individual does not use a network pharmacy, the covered individual must submit a claim to the Pharmacy Benefits Manager. If a covered individual's prescription was filled with a generic drug or a preferred brand-name or a non-preferred brand-name drug with no generic equivalent, the covered individual will be reimbursed up to the amount the program would reimburse a network pharmacy for that prescription. If the covered individual's prescription was filled with a preferred brand-name or a non-preferred brand-name drug that has a generic equivalent, the covered individual will be reimbursed up to the amount the program would reimburse a network pharmacy for filling the prescription with the drug's generic equivalent.

Prescription Drug Program. Non-Network If a covered individual does not use a network pharmacy, the covered individual must submit a claim to the Pharmacy Benefits Manager. If a covered individual's prescription was filled with a generic drug or a preferred brand-brand name or a non-preferred brand-brand name drug with no generic equivalent, the covered individual will be reimbursed up to the amount the program would reimburse a network pharmacy for that prescription. If the covered individual's prescription was filled with a preferred brand-brand name or a non-preferred brand-brand name drug that has a generic equivalent, the covered individual will be reimbursed up to the amount the program would reimburse a network pharmacy for filling the prescription with the drug's generic equivalent.