Common use of Prescription Plan Clause in Contracts

Prescription Plan. The prescription plan is bundled with a Medical plan, meaning the pharmacy benefit can only be accessed if the employee has enrolled in a UT medical plan. For generic drugs, the employee gets the cheaper of cost + $1 or flat fee. Retail UT Pharmacy Locations 30-day supply Tier 1 (Generic) Only a 10 day emergency supply is available @ $7.99 $7.99 Tier 2 (preferred Brand) Only a 10 day emergency supply is available @ $19.97 $19.97 Tier 3 (non-preferred Brand) Only a 10 day emergency supply is available @ $39.93 $39.93 31-90 day supply Tier 1 (Generic) n/a $19.97 Tier 2 (preferred brand) n/a $37.27 Tier 3 (non-preferred brand) n/a $73.93 Full-time regular permanent and eligible regular permanent part-time employees may have a prescription filled at both of the University of Toledo Out-Patient Pharmacies while enrolled in a University of Toledo sponsored medical/prescription plan. Non-emergent prescriptions can be dropped off in the OP Pharmacy during normal business hours or in the prescription drop box at any time but will only be available to be picked up in the OP pharmacy during regular outpatient pharmacy hours. Only cash, credit, or debit cards will be accepted as forms of payment. Emergent prescriptions when the OP pharmacy is closed can be filled at any University sponsored plan participating pharmacy for an emergency 10-day supply. Employees may be able to fill prescriptions under their spouse’s health plan as well as pick up over the counter medications and other supplies. The Outpatient pharmacy staff can assist in identifying coverage under other plans. Members are expected to show their current prescription benefit card, supplied to you by the prescription benefit manager, at the time of fill. Prescriptions may be filled for up to a 3 month period based on valid Physician order. If an employee insists on a brand name drug when a generic is available, they will have to pay 100% of the difference between the generic cost and the brand name drug cost. The formulary used will be the National formulary of the current prescription benefit manager including preauthorization, quantity management and Step Therapy protocols. Non-specialty medication prescriptions may be filled at the UT pharmacies for up to a 90-day supply based on valid provider order. Specialty medications are limited to UT pharmacies and will be filled for a 30-day supply. Other than prescriptions for chronic conditions, over the counter drugs will not be covered under the prescription benefit.

Prescription Plan. The prescription plan is bundled with a Medical plan, meaning the pharmacy benefit can only be accessed if the employee has enrolled in a UT medical plan. For generic drugs, the employee gets the cheaper of cost + $1 or flat fee. Retail UT Pharmacy Locations 30-day supply Tier 1 (Generic) Only a 10 day emergency supply is available @ $7.99 $7.99 Tier 2 (preferred Brand) Only a 10 day emergency supply is available @ $19.97 $19.97 Tier 3 (non-preferred Brand) Only a 10 day emergency supply is available @ $39.93 $39.93 31-90 day supply Tier 1 (Generic) n/a $19.97 Tier 2 (preferred brand) n/a $37.27 Tier 3 (non-preferred brand) n/a $73.93 Full-time regular permanent and eligible regular permanent part-time employees may have a prescription filled at both of the University of Toledo Out-Patient Pharmacies while enrolled in a University of Toledo sponsored medical/prescription plan. Non-emergent prescriptions can be dropped off in the OP Pharmacy during normal business hours or in the prescription drop box at any time but will only be available to be picked up in the OP pharmacy during regular outpatient pharmacy hours. Only cash, credit, or debit cards will be accepted as forms of payment. Emergent prescriptions when the OP pharmacy is closed can be filled at any University sponsored plan participating pharmacy for an emergency 10-day supply. Employees may be able to fill prescriptions under their spouse’s health plan as well as pick up over the counter medications and other supplies. The Outpatient pharmacy staff can assist in identifying coverage under other plans. Members are expected to show their current prescription benefit card, supplied to you by the prescription benefit manager, at the time of fill. Prescriptions may be filled for up to a 3 month period based on valid Physician order. If an employee insists on a brand name drug when a generic is available, they will have to pay 100% of the difference between the generic cost and the brand name drug cost. The formulary used will be the National formulary of the current prescription benefit manager including preauthorization, quantity management and Step Therapy protocols. Non-specialty medication prescriptions may be filled at the UT pharmacies for up to a 90-day supply based on valid provider order. Specialty medications are limited to UT pharmacies and will be filled for a 30-day supply. Other than prescriptions for chronic conditions, over the counter drugs will not be covered under the prescription benefit.