Coverage for prescription drugs is subject to the pharmacy program. The pharmacy program’s formulary includes a five-tier copayment structure and requires prescription drug preauthorization for certain Prescription Drugs. It also includes dose optimization conditions. Each of these items is described in more detail below. Coverage is provided for prescription drugs bought at a pharmacy, per the terms, conditions, exclusions, and limitations of this agreement.
Appears in 16 contracts
Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement
Coverage for prescription drugs is subject to the pharmacy program. The pharmacy program’s formulary program includes a fivefour-tier copayment structure and requires prescription drug preauthorization for certain Prescription Drugsprescription drugs. It also includes dose optimization conditions. Each of these items is described in more detail below. Coverage is provided for prescription drugs bought at a pharmacy, per the terms, conditions, exclusions, and limitations of this agreement.
Appears in 1 contract
Samples: Subscriber Agreement
