Prescription Drug Services Note Sample Clauses

Prescription Drug Services Note. Benefits for specialty drugs and injectable drugs that are not specialty drugs, excluding insulin, are as described in this section regardless of the place of service where the specialty drug or injectable drug that is not a specialty drug is dispensed or administered. Please see the Preventive Health Care Services section for coverage of prescription drugs, including certain insulin and other glucose lowering agents, on PIC’s Preventive Drug List. Drugs identified for our Split Fill Program may be provided in a 7 or 15 calendar day supply per prescription or refill even if prescribed for 31 calendar days. The copayment (if applicable) will be prorated. For a list of drugs on the Split Fill Program go to the member site on xxx.xxxxxxxxxxxx.xxx or call Customer Service. • Prescription drugs that can be self-administered for up to a 31- calendar day supply per prescription or refill. Tier 1 Generic: 100% of eligible charges after a $25 member copayment per prescription or refill. Deductible does not apply. Tier 2 Generic: 100% of eligible charges after a $25 member copayment per prescription or refill. Deductible does not apply. Preferred Brand: 70% of eligible charges after the deductible. Non-Preferred Brand and Non-formulary: Not covered. Not covered. • Mail order prescription drugs for up to a 31-calendar day supply per prescription or refill. Tier 1 Generic: 100% of eligible charges after a $25 member copayment per prescription or refill. Deductible does not apply. Tier 2 Generic: 100% of eligible charges after a $25 member copayment per prescription or refill. Deductible does not apply. Preferred Brand: 70% of eligible charges after the deductible. Non-Preferred Brand and Non-formulary: Not covered. Not covered. • Diabetic supplies, including over- the-counter diabetic supplies, including glucose monitors, syringes, blood and urine test strips, and other diabetic supplies as medically necessary. 70% of eligible charges after the deductible. Not covered. • Injectable drugs up to a 31– calendar day supply per prescription or refill, except specialty drugs, women’s contraceptives, and insulin. NOTE: Injectable drugs, except insulin, will not be covered at the tier 1 generic, tier 2 generic, preferred brand or mail order benefit level. Tier 1 Generic: 50% of eligible charges after the deductible. Tier 2 Generic: 50% of eligible charges after the deductible. Preferred Brand: 50% of eligible charges after the deductible. Non-Preferred Brand and Non-formulary...
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Prescription Drug Services Note. Benefits for specialty drugs and injectable drugs that are not specialty drugs, excluding insulin, are as described in this section regardless of the place of service where the specialty drug or injectable drug that is not a specialty drug is dispensed or administered. Please see the Preventive Health Care Services section for coverage of prescription drugs, including certain insulin and other glucose lowering agents, on PIC’s Preventive Drug List. Drugs identified for our Split Fill Program may be provided in a 7 or 15 calendar day supply per prescription or refill even if prescribed for 31 calendar days. The copayment (if applicable) will be prorated. For a list of drugs on the Split Fill Program go to the member site on xxx.xxxxxxxxxxxx.xxx or call Customer Service.
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Related to Prescription Drug Services Note

  • Prescription Drug Plan Effective January 1, 2022, retail and mail order prescription drug copays for bargaining unit employees shall be as follows: Type of Drug Prescriptions for 1-45 Days (1 copay) Prescriptions for 46-90 Days (2 copays) Generic drug $10 $20 Preferred brand name drug $25 $50 Non- referred brand name drug $40 $80 Effective January 1, 2022, for each plan year the Prescription Drug annual out-of-pocket copay maximum shall be $1,000 for individual coverage and $1,500 for employee and spouse, employee and child, or employee and family coverage.

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  • Prescription Safety Glasses Prescription safety glasses will be furnished by the employer. The employer retains the authority to establish reasonable rules and procedures regarding frequency of issue, replacement of damaged glasses, limits on reimbursement costs and coordination with the employer's vision plan.

  • REGULATORY ADMINISTRATION SERVICES BNY Mellon shall provide the following regulatory administration services for each Fund and Series:  Assist the Fund in responding to SEC examination requests by providing requested documents in the possession of BNY Mellon that are on the SEC examination request list and by making employees responsible for providing services available to regulatory authorities having jurisdiction over the performance of such services as may be required or reasonably requested by such regulatory authorities;  Assist with and/or coordinate such other filings, notices and regulatory matters and other due diligence requests or requests for proposal on such terms and conditions as BNY Mellon and the applicable Fund on behalf of itself and its Series may mutually agree upon in writing from time to time; and

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  • Approved Services; Additional Services Registry Operator shall be entitled to provide the Registry Services described in clauses (a) and (b) of the first paragraph of Section 2.1 in the Specification 6 attached hereto (“Specification 6”) and such other Registry Services set forth on Exhibit A (collectively, the “Approved Services”). If Registry Operator desires to provide any Registry Service that is not an Approved Service or is a material modification to an Approved Service (each, an “Additional Service”), Registry Operator shall submit a request for approval of such Additional Service pursuant to the Registry Services Evaluation Policy at xxxx://xxx.xxxxx.xxx/en/registries/rsep/rsep.html, as such policy may be amended from time to time in accordance with the bylaws of ICANN (as amended from time to time, the “ICANN Bylaws”) applicable to Consensus Policies (the “RSEP”). Registry Operator may offer Additional Services only with the written approval of ICANN, and, upon any such approval, such Additional Services shall be deemed Registry Services under this Agreement. In its reasonable discretion, ICANN may require an amendment to this Agreement reflecting the provision of any Additional Service which is approved pursuant to the RSEP, which amendment shall be in a form reasonably acceptable to the parties.

  • Program Services a) Personalized Care Practice agrees to provide to Program Member certain enhancements and amenities to professional medical services to be rendered by Personalized Care Practice to Program Member, as further described in Schedule 1 to these Terms. Upon prior written notice to Program Member, Personalized Care Practice may add or modify the Program Services set forth in Schedule 1, as reasonably necessary, and subject to such additional fees and/or terms and conditions as may be reasonably necessary.

  • Procurement of Goods and Services (a) If the HSP is subject to the procurement provisions of the BPSAA, the HSP will abide by all directives and guidelines issued by the Management Board of Cabinet that are applicable to the HSP pursuant to the BPSAA.

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