Common use of Specialty Drugs Clause in Contracts

Specialty Drugs. Community Health Options® has partnered with our Pharmacy Benefit Manager to implement a specialty drug program that: increases savings to our Members and the Plan; improves Member adherence; and allows Health Options’ Members 24/7 access to specialty-trained pharmacists and nurses to improve clinical outcomes. In order to pay the cost-sharing listed on your Schedule of Benefits for specialty drugs, they must be filled through our Preferred Specialty Pharmacy. The Preferred Specialty Pharmacy is established by Community Health Options and is subject to change at our discretion. These drugs are indicated on the Formulary as ‘mandatory specialty’. Specialty medications are limited to a 30-day supply, except where the medication is prepackaged and cannot be broken down into a smaller quantity. Certain specialty drugs are considered “mandatory” or “exclusive specialty” and must be filled through our Preferred Specialty Pharmacy, as defined on the Health Options Formulary. If you fill these prescriptions at a pharmacy that is not the Preferred Specialty Pharmacy, you will be responsible for 100% of the drug cost. These costs are not covered by the Plan and will not apply to your Out-of-Pocket costs. For certain specialty drugs the Plan offers one courtesy fill at a retail pharmacy as a covered benefit, as defined on the Health Options Formulary. Further fills of this specialty drug must be obtained directly through the exclusive specialty pharmacy, or you will be required to pay 100% of the allowed drug cost. In this case, the full allowed cost will apply to your Out-of-Pocket maximum.

Specialty Drugs. Community Health Options® has partnered with our Pharmacy Benefit Manager to implement a specialty drug program that: increases savings to our Members and the Plan; improves Member adherence; and allows Health Options’ Members 24/7 access to specialty-trained pharmacists and nurses to improve clinical outcomes. In order to pay the cost-sharing listed on your Schedule of Benefits for specialty drugs, they must be filled through our Preferred Specialty Pharmacy. The Preferred Specialty Pharmacy is established by Community Health Options and is subject to change at our discretion. These drugs are indicated on For most specialty drugs, you may fill your prescriptions at a pharmacy other than our Preferred Specialty Pharmacy but you will be required to pay 100% of the Formulary as ‘mandatory specialty’allowed drug cost. Specialty medications are limited In this case, the full allowed cost will apply to a 30your Out-day supply, except where the medication is prepackaged and cannot be broken down into a smaller quantityof-Pocket maximum. Certain specialty drugs are considered “mandatory” or “exclusive specialty” and must be filled through our Preferred Specialty Pharmacy, as defined . These drugs are indicated on the Health Options Formularyformulary as mandatory specialty. If you fill these prescriptions at a pharmacy that is not the Preferred Specialty Pharmacy, you will be responsible for 100% of the drug cost. These costs are not covered by the Plan and will not apply to your Out-of-Pocket costs. For certain Certain specialty drugs are part of the Plan offers one courtesy fill at a retail pharmacy as a MBM program and are not covered benefit, as defined on if filled through the Preferred Specialty Pharmacy. These specialty drugs must be approved by the MBM and filled by your Provider to ensure coverage. Refer to the Community Health Options Formulary. Further fills of this website for further information about the specialty drug must be obtained directly through drugs included in the exclusive specialty pharmacy, or you will be required to pay 100% of the allowed drug cost. In this case, the full allowed cost will apply to your Out-of-Pocket maximumMBM program.

Specialty Drugs. Community Health Options® has partnered with our Pharmacy Benefit Manager to implement a specialty drug program that: increases savings to our Members and the Plan; improves Member adherence; and allows Health Options’ Members 24/7 access to specialty-trained pharmacists and nurses to improve clinical outcomes. In order to pay the cost-sharing listed on your Schedule of Benefits Benefits, for specialty drugs, they must be filled through our Preferred Specialty Pharmacy. The Preferred Specialty Pharmacy is established by Community Health Options Options® and is subject to change at our discretion. These drugs are indicated on For most specialty drugs, you may fill your prescriptions at a pharmacy other than our Preferred Specialty Pharmacy but you will be required to pay 100% of the Formulary as ‘mandatory specialty’allowed drug cost. Specialty medications are limited In this case, the full allowed cost will apply to a 30your Out-day supply, except where the medication is prepackaged and cannot be broken down into a smaller quantityof-Pocket maximum. Certain specialty drugs are considered “mandatory” or “exclusive specialty” and must be filled through our Preferred Specialty Pharmacy, as defined . These drugs are indicated on the Health Options Formularyformulary as mandatory specialty. If you fill these prescriptions at a pharmacy that is not the Preferred Specialty Pharmacy, you will be responsible for 100% of the drug cost. These costs are not covered by the Plan and will not apply to your Out-of-Pocket costs. For certain Certain specialty drugs are part of the Plan offers one courtesy fill at a retail pharmacy as a MBM program and are not covered benefit, as defined on if filled through the Preferred Specialty Pharmacy. These specialty drugs must be approved by the MBM and filled by your Provider to ensure coverage. Refer to the Community Health Options Formulary. Further fills of this website for further information about the specialty drug must be obtained directly through drugs included in the exclusive specialty pharmacy, or you will be required to pay 100% of the allowed drug cost. In this case, the full allowed cost will apply to your Out-of-Pocket maximumMBM program.

Specialty Drugs. Community Health Options® Options has partnered with our Pharmacy Benefit Manager to implement a specialty drug program that: increases savings to our Members and the Plan; improves Member adherence; and allows Community Health Options’ Members 24/7 access to specialty-trained specialty‐trained pharmacists and nurses to improve clinical outcomes. In order to pay the cost-sharing cost‐sharing listed on your Schedule of Benefits for specialty drugs, they must be filled through our Preferred Specialty Pharmacy. The Preferred Specialty Pharmacy is established by Community Health Options and is subject to change at our discretion. These drugs are indicated on the Formulary as ‘mandatory specialty’. Specialty medications are limited to a 30-day 30‐day supply, except where the medication is prepackaged and cannot be broken down into a smaller quantity. Certain specialty drugs are considered “mandatory” or “exclusive specialty” and must be filled through our Preferred Specialty Pharmacy, as defined on the Community Health Options Formulary. If you fill these prescriptions at a pharmacy that is not the Preferred Specialty Pharmacy, you will be responsible for 100% of the drug cost. These costs are not covered by the Plan and will not apply to your Out-of-Pocket Out‐of‐Pocket costs. For certain specialty drugs the Plan offers one courtesy fill at a retail pharmacy as a covered benefit, as defined on the Community Health Options Formulary. Further fills of this specialty drug must be obtained directly through the exclusive specialty pharmacy, or you will be required to pay 100% of the allowed drug cost. In this case, the full allowed cost will apply to your Out-of-Pocket Out‐of‐Pocket maximum.

Specialty Drugs. Community Health Options® Options has partnered with our Pharmacy Benefit Manager to implement a specialty drug program that: increases savings to our Members and the Plan; improves Member adherence; and allows Community Health Options’ Members 24/7 access to specialty-trained specialty‐trained pharmacists and nurses to improve clinical outcomes. In order to pay the cost-sharing cost‐sharing listed on your Schedule of Benefits for specialty drugs, they must be filled through our Preferred Specialty Pharmacy. The Preferred Specialty Pharmacy is established by Community Health Options and is subject to change at our discretion. These drugs are indicated on the Formulary as ‘“mandatory specialty’”. Specialty medications are limited to a 30-day 30‐day supply, except where the medication is prepackaged and cannot be broken down into a smaller quantity. Certain specialty drugs are considered “mandatory” or “exclusive specialty” and must be filled through our Preferred Specialty Pharmacy, as defined on the Community Health Options Formulary. If you fill these prescriptions at a pharmacy that is not the Preferred Specialty Pharmacy, you will be responsible for 100% of the drug cost. These costs are not covered by the Plan and will not apply to your Out-of-Pocket Out‐of‐Pocket costs. For certain specialty drugs the Plan offers one courtesy fill at a retail pharmacy as a covered benefit, as defined on the Community Health Options Formulary. Further fills of this specialty drug must be obtained directly through the exclusive specialty pharmacy, or you will be required to pay 100% of the allowed drug cost. In this case, the full allowed cost will apply to your Out-of-Pocket Out‐of‐Pocket maximum.

Specialty Drugs. Community Health Options® has partnered with our Pharmacy Benefit Manager to implement a specialty drug program that: increases savings to our Members and the Plan; improves Member adherence; and allows Health Options’ Members 24/7 access to specialty-trained pharmacists and nurses to improve clinical outcomes. In order to pay the cost-sharing listed on your Schedule of Benefits for specialty drugs, they must be filled through our Preferred Specialty Pharmacy. The Preferred Specialty Pharmacy is established by Community Health Options and is subject to change at our discretion. These drugs are indicated on the Formulary as ‘“mandatory specialty’”. Specialty medications are limited to a 30-day supply, except where the medication is prepackaged and cannot be broken down into a smaller quantity. Certain specialty drugs are considered “mandatory” or “exclusive specialty” and must be filled through our Preferred Specialty Pharmacy, as defined on the Health Options Formulary. If you fill these prescriptions at a pharmacy that is not the Preferred Specialty Pharmacy, you will be responsible for 100% of the drug cost. These costs are not covered by the Plan and will not apply to your Out-of-Pocket costs. For certain specialty drugs the Plan offers one courtesy fill at a retail pharmacy as a covered benefit, as defined on the Health Options Formulary. Further fills of this specialty drug must be obtained directly through the exclusive specialty pharmacy, or you will be required to pay 100% of the allowed drug cost. In this case, the full allowed cost will apply to your Out-of-Pocket maximum.

Specialty Drugs. Community Health Options® has partnered with our Pharmacy Benefit Manager to implement a specialty drug program that: increases savings to our Members and the Plan; improves Member adherence; and allows Health Options’ Members 24/7 access to specialty-trained pharmacists and nurses to improve clinical outcomes. In order to pay the cost-sharing listed on your Schedule of Benefits for specialty drugs, they must be filled through our Preferred Specialty Pharmacy. The Preferred Specialty Pharmacy is established by Community Health Options and is subject to change at our discretion. These drugs are indicated on the Formulary as ‘“mandatory specialty’”. Specialty medications are limited to a 30-day supply, except where the medication is prepackaged and cannot be broken down into a smaller quantity. Certain specialty drugs are considered “mandatory” or “exclusive specialty” and must be filled through our Preferred Specialty Pharmacy, as defined on the Health Options Formulary. If you fill these prescriptions at a pharmacy that is not the Preferred Specialty Pharmacy, you will be responsible for 100% of the drug cost. These costs are not covered by the Plan and will not apply to your Out-of-Pocket costs. For certain specialty drugs the Plan offers one courtesy fill at a retail pharmacy as a covered benefit, as defined on the Health Options Formulary. Further fills of this specialty drug must be obtained directly through the exclusive specialty pharmacy, or you will be required to pay 100% of the allowed drug cost. In this case, the full allowed cost will apply to your Out-of-Pocket maximum.. SAMPLE