Prescription Drugs Administered by a Provider Sample Clauses

Prescription Drugs Administered by a Provider. (other than a Pharmacy). See the Summary of Medical Benefits. See the
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Prescription Drugs Administered by a Provider. (other than a pharmacy) This plan covers prescription drugs dispensed and administered by a licensed healthcare provider (other than a pharmacy) with preauthorization. Coverage varies based upon how the prescription drug is administered, as described below. When a prescription drug is provided through inhalation, nasal, ocular, oral, rectal, vaginal, sublingual, topical, or transdermal administration, coverage for the prescription drug is included in our allowance for the medical service being rendered. If the only service you receive is administration of the drug, the prescription drug is not covered. When a prescription drug is administered by injection or infusion, this plan covers the prescription drug separately from the medical service being rendered. See the Summary of Medical Benefits for benefit limits and the amount you pay. Specialty prescription drugs are not separately reimbursed when dispensed by a professional provider unless bought from a network pharmacy.

Related to Prescription Drugs Administered by a Provider

  • Prescription Drugs The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types of treatments limit is preauthorization. Preauthorization is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. Mental disorders are covered under Section A. Mental Health Services. Substance use disorders are covered under Section

  • Orally Administered Anticancer Medication In accordance with RIGL § 27-20-67, prescription drug coverage for orally administered anticancer medications is provided at a level no less favorable than coverage for intravenously administered or injected cancer medications covered under your medical benefit.

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