A prescription drug Sample Clauses

A prescription drug. 2. Any drug that, under the applicable state law, may be dispensed only upon the written prescription by a physician. See the Formulary and Schedule of Benefits for additional information on drug coverage, benefit levels or additional limits. The appropriate drug choice for a member is a determination that is best made by the member and his or her physician. Non-Formulary Prescription Drugs: Under Affordable Care Act, you have the right to request coverage of prescription drugs that are not listed on the plan formulary (otherwise known as “non-formulary drugs”). To exercise this right, please get in touch with your medical practitioner. Your medical practitioner can utilize the usual prior authorization request process. See “Prior Authorization” below for additional details. Prescription Drug Exception Process
Sample 1Sample 2Sample 3
AutoNDA by SimpleDocs
A prescription drug. 2. Any drug that, under the applicable state law, may be dispensed only upon the written prescription by a physician. See the Preferred Drug List and Schedule of Benefits for additional information on drug coverage, benefit levels or additional limits. The appropriate drug choice for a member is a determination that is best made by the member and his or her physician. Notice and Proof of Loss: In order to obtain payment for covered service expenses incurred at a pharmacy for prescription orders, a notice of claim and proof of loss must be submitted directly to us. Non-Covered Services and Exclusions: No benefits will be paid under this benefit subsection for services provided or expenses incurred:
Sample 1Sample 2Sample 3
A prescription drug. 2. Any drug that, under the applicable state law, may be dispensed only upon the written prescription by a physician. See the Formulary and Schedule of Benefits for additional information on drug coverage, benefit levels or additional limits. The appropriate drug choice for a member is a determination that is best made by the member and his or her physician. Non-Formulary Prescription Drugs: Under Affordable Care Act, you have the right to request coverage of prescription drugs that are not listed on the plan formulary (otherwise known as “non-formulary drugs”). To exercise this right, please get in touch with your medical practitioner. Your medical practitioner can utilize the Prescription Drug Exception request process. Drug Discount, Coupon or Copay Card Cost sharing paid on your behalf for any prescription drugs obtained by you through the use of a drug discount, coupon, or copay card provided by a prescription drug manufacturer will not apply toward your plan deductible or your maximum out of pocket.
Sample 1Sample 2

Related to A prescription drug

  • 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

  • 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.

  • Prescription Glasses This plan covers prescription glasses as follows: • Frames - one (1) collection frame per plan year; • Lenses - one (1) pair of glass or plastic collection lenses per plan year. This includes single vision, bifocal, trifocal, lenticular, and standard progressive lenses. This plan covers the following lens treatments: • UV treatment; • tint (fashion, gradient, and glass-grey); • standard plastic scratch coating; • standard polycarbonate; and • photocromatic/transitions plastic. Contact Lenses (in lieu of prescription glasses) This plan covers one (1) supply of contact lenses as follows: • conventional contact lenses - one (1) pair per plan year from a selection of provider designated contact lenses; or • extended wear disposable lenses - up to a 6-month supply of monthly or two- week single vision spherical or toric disposable contact lenses per plan year; or • daily wear disposable lenses - up to a 3-month supply of daily single vision spherical disposable contact lenses per plan year. This plan also covers the evaluation, fitting, or follow-up care related to contact lenses. This plan covers additional contact lenses if your prescribing network provider submits a verification form, with the regular claim form, verifying that you have one of the following conditions: • anisometropia of 3D in meridian powers; • high ametropia exceeding -10D or +10D in meridian powers; • keratoconus when the member’s vision is not correctable to 20/25 in either or both eyes using standard spectacle lenses; and • vision improvement for members whose vision can be corrected two lines of improvement on the visual acuity chart when compared to the best corrected standard spectacle lenses.

  • 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.

  • Prescription Claims against the Issuer or any Guarantor for the payment of principal or Additional Amounts, if any, on the Notes will be prescribed ten years after the applicable due date for payment thereof. Claims against the Issuer or any Guarantor for the payment of interest on the Notes will be prescribed five years after the applicable due date for payment of interest.

  • Alcohol and Drug Testing Employee agrees to comply with and submit to any Company program or policy for testing for alcohol abuse or use of drugs and, in the absence of such a program or policy, to submit to such testing as may be required by Company and administered in accordance with applicable law and regulations.

  • Random Drug Testing All employees covered by this Agreement shall be subject to random drug testing in accordance with Appendix D.

  • Brand Name Drugs If the subscriber chooses a brand name drug when a bioequivalent generic drug is available, the subscriber is required to pay the standard copayment plus the difference between the cost of the brand name drug and the generic. Amounts above the copay that an individual elects to pay for a brand name instead of a generic drug will not be credited toward the out-of-pocket maximum.

  • DRUG/ALCOHOL TESTING 8.1 The parties agree that the maintenance of a drug/alcohol free work place is a goal of both the College and the Union. Employees are prohibited from possession, consumption and/or being under the influence of a controlled substance/alcohol while on the College’s premises or during time paid by the employer. Violations of this prohibition may result in a disciplinary action up to and including termination.

  • Prescription Plan The PPO plan will include a comprehensive prescription 37 program: 38

Time is Money Join Law Insider Premium to draft better contracts faster.