Prescription drug deductible amount means the amount of covered expenses, shown in the Schedule of Benefits, if applicable, that must actually be paid during any calendar year before any prescription drug benefits are payable. The family prescription drug deductible amount is two times the individual prescription drug deductible amount. For family coverage, once a covered person has met the individual prescription drug deductible amount, any remaining family prescription drug deductible amount can be met with the combination of any one or more covered persons’ eligible service expenses.
Prescription drug deductible amount. The dollar amount, if shown in the Schedule of Benefits, which each Member must pay within a Benefit Period prior to paying a Prescription Drug Copayment. The Prescription Drug Deductible Amount does not accrue to the Benefit Period Deductible Amount or the Family Deductible Amount. Prescription Drug Formulary – A list of specific Prescription Drugs that are covered under this insurance policy. Preventive or Wellness Care – Services designed to effectively prevent or screen for a disease for which there is an effective treatment when discovered in an early stage. Primary Care Physician (PCP) - A Physician who is a Family Practitioner, General Practitioner, Internist, or Pediatrician. Private Duty Nursing Services – Services of an actively practicing Registered Nurse (R.N.) or Licensed Practical Nurse (L.P.N.) who is unrelated to the patient by blood, marriage or adoption. These services must be ordered by the attending Physician and require the technical skills of an R.N. or L.P.N. Prosthetic Appliance or Device – Appliances which replace all or part of a body organ, or replace all or part of the function of a permanently inoperative, absent, or malfunctioning body part. When referring to limb prostheses, it is an artificial limb designed to maximize function, stability, and safety of the patient, that is not surgically implanted and that is used to replace a missing limb. Limb Prosthetics do not include artificial eyes, ears, noses, dental appliances, ostomy products, or devices such as eyelashes or wigs. Prosthetic Services – The science and practice of evaluating, measuring, designing, fabricating, assembling, fitting, aligning, adjusting, or servicing of a prosthesis through the replacement of external parts of a human body lost due to amputation or congenital deformities to restore function, cosmesis, or both. Also includes Medically Necessary clinical care. Provider – A Hospital, Allied Health Facility, Physician, or Allied Health Professional, licensed where required, performing within the scope of license, and approved by Us. If a Provider is not subject to state or federal licensure, We have the right to define all criteria under which a Provider’s services may be offered to Our Members in order for Benefits to apply to a Provider’s Claims. Claims submitted by Providers who fail to meet these criteria will be denied.
Prescription drug deductible amount means the amount of covered expenses, shown in the Schedule of Benefits, if applicable, that must actually be paid during any calendar year before any prescription drug benefits are payable. The family prescription drug deductible amount is two times the individual prescription drug deductible amount. For family coverage, once a covered person has met the individual prescription drug deductible amount, any remaining family prescription drug deductible amount can be met with the combination of any one or more covered persons’ eligible service expenses. Primary care provider (PCP) means a provider who gives or directs health care services for you. PCPs include internists, family practitioners, general practitioners, Advanced Practice Registered Nurses (APRN), Physician Assistants (PA), obstetrician gynecologist (ob-gyn) and pediatricians or any other practice allowed by the plan. A PCP supervises, directs and gives initial care and basic medical services to you and is in charge of your ongoing care.
Examples of Prescription drug deductible amount in a sentence
Prescription drug means any medicinal substance whose label is required to bear the legend "RX only." Prescription drug deductible amount means the amount of covered expenses, shown in the Schedule of Benefits, if applicable, that must actually be paid during any calendar year before any prescription drug benefits are payable.