Generic Substitution Sample Clauses

Generic Substitution. If a brand is dispensed when there’s a generic equivalent available, the member will be responsible for the brand copayment plus the difference in cost between the brand and the generic drug.
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Generic Substitution. The maximum amount payable for an eligible brand name drug will be limited to the lowest priced item in the appropriate generic category. Limitations and Exclusions No benefit is payable for the portion of expenses for which reimbursement is provided by a government expenses for drugs which, in Mutual's opinion, are experimental, expenses for dietary supplements, vitamins and infant foods, expenses for contraceptives (other than oral), expenses for smoking cessation aids, expenses for drugs if they are used for the treatment of infertility, the yearly or per prescription deductible on drugs that are eligible under the Ontario Drug Benefit plan and are purchased by you or your insured spouse who is age or over. Extended Health Primary and Secondary Pay Direct Drug Benefit May Extended Health Vision Benefit Eligible Expenses Eligible expenses mean reasonable and customary charges for the following items of expense eye examinations by an optometrist, but for not more than one examination in a period of months (12 months for a dependent child under age 18); eyeglasses and contact lenses provided such appliances are necessary for the correction of vision and are prescribed by an ophthalmologist or optometrist, and repairs to such appliances, subject to maximum total eligible expenses of during the month period ending on the date an eligible expense for such appliances is incurred; eyeglasses and contact lenses where an ophthalmologist certifies that such appliances are necessary as a result of a surgical procedure or for the treat- ment of keratoconus subject to maximum total lifetime eligible expenses of in respect of any one surgical procedure or for the treatment of keratoconus.
Generic Substitution. The drug plan will be modified as necessary to require generic substitution for drugs covered by the plan unless otherwise prescribed by the employee's doctor.
Generic Substitution. When there is a generic version of a brand-name drug available, our network pharmacies may recommend and/or provide you the generic version, unless your doctor has told us that you must take the brand- name drug and we have approved this request. You can find out if the drug you take is subject to these additional requirements or limits by looking in the formulary or on our xxx.xxx.xxx/xxxxxxxx, or by calling Customer Service. If your drug is subject to one of these additional restrictions or limits and your physician determines that you aren’t able to meet the additional restriction or limit for medical necessity reasons, you or your physician may request an exception (which is a type of coverage determination). See Section 5 for more information about how to request an exception. Drug utilization review We conduct drug utilization reviews for all of our members to make sure that they are getting safe and appropriate care. These reviews are especially important for members who have more than one doctor who prescribes their medications. We conduct drug utilization reviews each time you fill a prescription and on a regular basis by reviewing our records. During these reviews, we look for medication problems such as: • Possible medication errors • Duplicate drugs that are unnecessary because you are taking another drug to treat the same medical condition • Drugs that are inappropriate because of your age or gender • Possible harmful interactions between drugs you are taking • Drug allergies • Drug dosage errors If we identify a medication problem during our drug utilization review, we will work with your doctor to correct the problem. Medication therapy management programs We offer medication therapy management programs at no additional cost to members who have multiple medical conditions, who are taking many prescription drugs, and who have high drug costs. These programs were developed for us by a team of pharmacists and doctors. We use these medication therapy management programs to help us provide better coverage for our members. For example, these programs help us make sure that our members are using appropriate drugs to treat their medical conditions and help us identify possible medication errors. We may contact members who qualify for these programs. If we contact you, we hope you will join so that we can help you manage your medications. Remember, you don’t need to pay anything extra to participate. If you are selected to join a medication therapy m...

Related to Generic Substitution

  • PRODUCT SUBSTITUTION In the event a specified manufacturer’s Product listed in the Contract becomes unavailable or cannot be supplied by the Contractor for any reason (except as provided for in the Savings/Force Majeure Clause) a Product deemed in writing by the Commissioner to be equal to or better than the specified Product must be substituted by the Contractor at no additional cost or expense to the Authorized User. Unless otherwise specified, any substitution of Product prior to the Commissioner’s written approval may be cause for cancellation of Contract.

  • Substitution of Equipment In the event the Computer is inoperable, ASL has a limited number of spare laptops for use while the Computer is being repaired or replaced. This agreement remains in effect for such a substitute. The Student may NOT opt to keep a broken Computer or to avoid using the Computer due to loss or damage.

  • Internal Substitution A. Every reasonable effort will be made to secure substitutes for teachers when they are absent from duty.

  • Substitution of Concessionaire At any time during the period of Suspension, the Lenders‟ Representative, on behalf of Senior Lenders, shall be entitled to substitute the Concessionaire under and in accordance with the Substitution Agreement, and upon receipt of notice thereunder from the Lenders‟ Representative, the Authority shall withhold Termination for a period not exceeding 180 (one hundred and eighty) days from the date of Suspension, and any extension thereof under Clause 36.1, for enabling the Lenders‟ Representative to exercise its rights of substitution on behalf of Senior Lenders.

  • Third Party Components The Products and Services may contain third party components (including open source software) subject to separate license agreements. To the limited extent a third party license expressly supersedes this XXXX, such third party license governs Customer’s use of that third party component.

  • No Removal or Substitution The Resident may not remove, alter or change any property in the Room which is provided on occupancy or at any other time during the Term, including and not limited to; furnishings, fixtures, equipment, television sets, appliances, window screens, floor coverings and any mattress covering. The Resident shall use all such items only for their intended purpose.

  • Chemical Substances Supplier warrants that: (i) each chemical substance contained in Products is on the inventory of chemical substances compiled and published by the Environmental Protection Agency pursuant to the Toxic Substances Control Act and (ii) all Material Safety Data Sheets required to be provided by Supplier for Products shall be provided to DXC prior to shipment of the Products and shall be complete and accurate.

  • REPAIRED OR REPLACED PRODUCTS, PARTS, OR COMPONENTS Where the Contractor is required to repair, replace or substitute Product or parts or components of the Product under the Contract, the repaired, replaced or substituted Products shall be subject to all terms and conditions for new parts and components set forth in the Contract including warranties, as set forth in the Warranties clause herein. Replaced or repaired Product or parts and components of such Product shall be new and shall, if available, be replaced by the original manufacturer’s component or part. Remanufactured parts or components meeting new Product standards may be permitted by the Commissioner or Authorized User. Before installation, all proposed substitutes for the original manufacturers’ installed parts or components must be approved by the Authorized User. The part or component shall be equal to or of better quality than the original part or component being replaced.

  • Wholly Obtained or Produced Goods For purposes of Article 3.1.1(a), the following goods are wholly obtained or produced entirely in the territory of one or both of the Parties: (a) live animals born and raised in the territory of Korea or Peru; (b) goods obtained from live animals born and raised in the territory of Korea or Peru; (c) goods obtained by hunting, trapping, fishing, or aquaculture in the territory of Korea or Peru1; (d) goods of sea-fishing and other goods taken from the sea outside the territory of a Party by vessels registered or recorded with a Party and flying its flag; (e) goods produced on board factory ships, exclusively from the goods referred to in subparagraph (d), provided that such factory ships are registered or recorded with a Party and fly its flag; (f)

  • Permitted License Transfers As Licensee’s business operations may be altered, expanded or diminished, licenses granted hereunder may be transferred or combined for use at an alternative or consolidated site not originally specified in the license, including transfers between Agencies (“permitted license transfers”). Licensee(s) do not have to obtain the approval of Contractor for permitted license transfers, but must give thirty (30) days prior written notice to Contractor of such move(s) and certify in writing that the Product is not in use at the prior site. There shall be no additional license or other transfer fees due Contractor, provided that: i) the maximum capacity of the consolidated machine is equal to the combined individual license capacity of all licenses running at the consolidated or transferred site (e.g., named users, seats, or MIPS); or ii) if the maximum capacity of the consolidated machine is greater than the individual license capacity being transferred, a logical or physical partition or other means of restricting access will be maintained within the computer system so as to restrict use and access to the Product to that unit of licensed capacity solely dedicated to beneficial use for Licensee. In the event that the maximum capacity of the consolidated machine is greater than the combined individual license capacity of all licenses running at the consolidated or transferred site, and a logical or physical partition or other means of restricting use is not available, the fees due Contractor shall not exceed the fees otherwise payable for a single license for the upgrade capacity.

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