Examples of Plan Pharmacy in a sentence
Benefits for Covered Drugs obtained at a Designated Plan Pharmacy are payable according to the applicable benefit tiers described below, subject to the Member obtaining any required Prior Authorization or meeting any applicable Step Therapy requirement.
You must obtain these drugs from a Plan Pharmacy or a Participating Network Pharmacy.
For drugs prescribed by a dentist, coverage is limited to antibiotics and pain relief drugs that are included on our Preferred Drug List and purchased at a Plan Pharmacy or a Participating Network Pharmacy.
If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, HPN may direct you to a Designated Plan Pharmacy with whom HPN has an arrangement to provide those Covered Drugs.
The fact that a pharmacy is a Plan Pharmacy does not mean that it is a Designated Plan Pharmacy.
If you choose not to use the Designated Plan Pharmacy and instead have the Specialty Covered Drugs dispensed by a non-Designated Plan Retail Pharmacy, you will be responsible for paying two times the amount of the Specialty Covered Drug Tier Copayment and/or Coinsurance as stated in the applicable plan Attachment A, Schedule of Benefits.
IYC Health Plan Pharmacy Benefits are also the IN-NETWORK benefits for the IYC ACCESS PLAN.
Benefit coverage will be paid only if the Insured uses the assigned single Plan Pharmacy.
Drugs dispensed by other than a Plan Pharmacy, except as Medically Necessary for treatment of an Emergency or urgent care condition.2. Drugs when prescribed by non-contracting providers that are not authorized by the Plan except when coverage is otherwise required in the context of Emergency Services.3. Over-the-counter medications or supplies, even if written on prescription, except as specifically identified as covered in the Sharp Health Plan Drug Formulary.
For more information about maintenance drugs, see the “HOW DO I OBTAIN MAINTENANCE DRUGS BY MAIL ORDER?” below.SHARP HEALTH PLAN DRUG LISTThe Sharp Health Plan Drug List (also known as a Formulary) was developed to identify the safest and most effective drugs for Members while attempting to maintain affordable pharmacy benefits.The Drug List is updated regularly, based on input from the Sharp Health Plan Pharmacy & Therapeutics (P&T) Committee, which meets quarterly.