Injectable Medications. Benefits will be provided for injectable medications required in the treatment of an injury or illness administered by a Participating Professional Provider. Specialty Medical Injectable Pharmaceuticals require Preauthorization. Injectables that are “primarily self-administered” are not covered under the Member’s medical benefit under any circumstances, even if the member is unable to self-administer. In the event a member is unable to self- administer an injectable medication, only the charges for the administration of the injectable will be covered when administered and reported by an eligible provider in an office, hospital outpatient, or home setting. Members can view the list of medications that Keystone considers to be primarily self-administered by accessing the Self-Administered Medications Policy at xxxxxxxxxxxx.xxx.
Appears in 6 contracts
Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement
