Common use of Inpatient Clause in Contracts

Inpatient. We cover inpatient drugs as a hospital service. See Glossary for definition of hospital services. Generic, preferred brand name, or non-preferred brand name prescription drugs are covered at different benefit levels depending upon the route of administration. Our allowance for services rendered by the facilities, agencies, and professional providers may include the cost of the prescription drugs administered and/or dispensed. We will determine coverage based upon the route of administration that is customary and least invasive method to treat the condition. There are several ways to administer drugs into the body including:  inhalation (into the lungs, usually through the mouth);  intramuscular (injected into a muscle);  intra-articular (injected into a skeletal joint space);  intrathecal (injected into the space around the spinal cord);  intravenous/infused/intra-arterial (into a vein or artery);  nasal (sprayed into the nose);  ocular (instilled in the eye);  oral (by mouth);  rectal or vaginal (inserted into the rectum or vagina);  subcutaneous (injected beneath the skin);  sublingual (under the tongue);  topical (applied to the skin); OR  transdermal (delivered through the skin by a patch). The prescription drug is included in our allowance for the medical service being rendered. If the sole service is drug dispensing, the prescription drug is NOT covered. We use the term injected to include prescription drugs approved by us given by intra muscular or subcutaneous injection or in the case of a body cavity by instillation. See the Summary of Medical Benefits for benefit limits and the amount that you pay. See Prevention and Early Detection Services section for immunization and vaccination coverage information. We use the term infused to include those prescription drugs approved by us and administered into a vein or into an artery whether by mixing in fluids and administering intravenously or into an artery, direct injection, or by use of a pump that accesses the vein or artery. See the Summary of Medical Benefits for benefit limits and the amount that you pay.

Inpatient. We cover inpatient drugs as a hospital service. See Glossary for definition of hospital services. Generic, preferred brand name, or non-preferred brand name prescription drugs are covered at different benefit levels depending upon the route of administration. Our allowance for services rendered by the facilities, agencies, and professional providers may include the cost of the prescription drugs administered and/or dispensed. We will determine coverage based upon the route of administration that is customary and least invasive method to treat the condition. There are several ways to administer drugs into the body including:  • inhalation (into the lungs, usually through the mouth);  • intramuscular (injected into a muscle);  • intra-articular (injected into a skeletal joint space);  • intrathecal (injected into the space around the spinal cord);  • intravenous/infused/intra-arterial (into a vein or artery);  • nasal (sprayed into the nose);  • ocular (instilled in the eye);  • oral (by mouth);  • rectal or vaginal (inserted into the rectum or vagina);  • subcutaneous (injected beneath the skin);  • sublingual (under the tongue);  • topical (applied to the skin); OR  • transdermal (delivered through the skin by a patch). The prescription drug is included in our allowance for the medical service being rendered. If the sole service is drug dispensing, the prescription drug is NOT covered. We use the term injected to include prescription drugs approved by us given by intra muscular or subcutaneous injection or in the case of a body cavity by instillation. See the Summary of Medical Benefits for benefit limits and the amount that you pay. See Prevention and Early Detection Services section for immunization and vaccination coverage information. We use the term infused to include those prescription drugs approved by us and administered into a vein or into an artery whether by mixing in fluids and administering intravenously or into an artery, direct injection, or by use of a pump that accesses the vein or artery. See the Summary of Medical Benefits for benefit limits and the amount that you pay.

Inpatient. We cover inpatient drugs as a hospital service. See Glossary for definition of hospital services. Generic, preferred brand name, or non-preferred brand name prescription drugs are covered at different benefit levels depending upon the route of administration. Our allowance for services rendered by the facilities, agencies, and professional providers may include the cost of the prescription drugs administered and/or dispensed. We will determine coverage based upon the route of administration that is customary and least invasive method to treat the condition. There are several ways to administer drugs into the body including:  • inhalation (into the lungs, usually through the mouth);  • intramuscular (injected into a muscle);  • intra-articular (injected into a skeletal joint space);  • intrathecal (injected into the space around the spinal cord);  • intravenous/infused/intra-arterial (into a vein or artery);  • nasal (sprayed into the nose);  • ocular (instilled in the eye);  • oral (by mouth);  • rectal or vaginal (inserted into the rectum or vagina);  • subcutaneous (injected beneath the skin);  • sublingual (under the tongue);  • topical (applied to the skin); OR  • transdermal (delivered through the skin by a patch). The prescription drug is included in our allowance for the medical service being rendered. If the sole service is drug dispensing, the prescription drug is NOT covered. Injected Generic, Preferred Brand Name or Non-Preferred Brand Name Prescription Drugs We use the term injected to include prescription drugs approved by us given by intra muscular or subcutaneous injection or in the case of a body cavity by instillation. See the Summary of Medical Benefits for benefit limits and the amount that you pay. See Prevention and Early Detection Services section for immunization and vaccination coverage information. Infused Generic, Preferred Brand Name, or Non-Preferred Brand Name Prescription Drugs We use the term infused to include those prescription drugs approved by us and administered into a vein or into an artery whether by mixing in fluids and administering intravenously or into an artery, direct injection, or by use of a pump that accesses the vein or artery. See the Summary of Medical Benefits for benefit limits and the amount that you pay.

Inpatient. We cover inpatient drugs as a hospital service. See Glossary for definition of hospital services. Generic, preferred brand name, or non-preferred brand name prescription drugs are covered at different benefit levels depending upon the route of administration. Our allowance for services rendered by the facilities, agencies, and professional providers may include the cost of the prescription drugs administered and/or dispensed. We will determine coverage based upon the route of administration that is customary and least invasive method to treat the condition. There are several ways to administer drugs into the body including:  inhalation (into the lungs, usually through the mouth);  intramuscular (injected into a muscle);  intra-articular (injected into a skeletal joint space);  intrathecal (injected into the space around the spinal cord);  intravenous/infused/intra-arterial (into a vein or artery);  nasal (sprayed into the nose);  ocular (instilled in the eye);  oral (by mouth);  rectal or vaginal (inserted into the rectum or vagina);  subcutaneous (injected beneath the skin);  sublingual (under the tongue);  topical (applied to the skin); OR  transdermal (delivered through the skin by a patch). The prescription drug is included in our allowance for the medical service being rendered. If the sole service is drug dispensing, the prescription drug is NOT covered. Injected Generic, Preferred Brand Name or Non-Preferred Brand Name Prescription Drugs We use the term injected to include prescription drugs approved by us given by intra muscular or subcutaneous injection or in the case of a body cavity by instillation. See the Summary of Medical Benefits for benefit limits and the amount that you pay. See Prevention and Early Detection Services section for immunization and vaccination coverage information. Infused Generic, Preferred Brand Name, or Non-Preferred Brand Name Prescription Drugs We use the term infused to include those prescription drugs approved by us and administered into a vein or into an artery whether by mixing in fluids and administering intravenously or into an artery, direct injection, or by use of a pump that accesses the vein or artery. See the Summary of Medical Benefits for benefit limits and the amount that you pay.

Inpatient. We cover inpatient drugs as a hospital service. See Glossary for definition of hospital services. Outpatient/In Your Doctor’s Office/In Your Home Generic, preferred brand name, or non-preferred brand name prescription drugs are covered at different benefit levels depending upon the route of administration. Our allowance for services rendered by the facilities, agencies, and professional providers may include the cost of the prescription drugs administered and/or dispensed. We will determine coverage based upon the route of administration that is customary and least invasive method to treat the condition. There are several ways to administer drugs into the body including:  • inhalation (into the lungs, usually through the mouth);  • intramuscular (injected into a muscle);  • intra-articular (injected into a skeletal joint space);  • intrathecal (injected into the space around the spinal cord);  • intravenous/infused/intra-arterial (into a vein or artery);  • nasal (sprayed into the nose);  • ocular (instilled in the eye);  • oral (by mouth);  • rectal or vaginal (inserted into the rectum or vagina);  • subcutaneous (injected beneath the skin);  • sublingual (under the tongue);  • topical (applied to the skin); OR  or • transdermal (delivered through the skin by a patch). The prescription drug is included in our allowance for the medical service being rendered. If the sole service is drug dispensing, the prescription drug is NOT covered. We use the term injected to include prescription drugs approved by us given by intra muscular or subcutaneous injection or in the case of a body cavity by instillation. See the Summary of Medical Benefits for benefit limits and the amount that you pay. See Prevention Preventive Care Services and Early Detection Services section for immunization and vaccination coverage information. We use the term infused to include those prescription drugs approved by us and administered into a vein or into an artery whether by mixing in fluids and administering intravenously or into an artery, direct injection, or by use of a pump that accesses the vein or artery. See the Summary of Medical Benefits for benefit limits and the amount that you pay.

Inpatient. We cover inpatient drugs as a hospital service. See Glossary for definition of hospital services. Outpatient/In Your Doctor’s Office/In Your Home Generic, preferred brand name, or non-preferred brand name prescription drugs are covered at different benefit levels depending upon the route of administration. Our allowance for services rendered by the facilities, agencies, and professional providers may include the cost of the prescription drugs administered and/or dispensed. We will determine coverage based upon the route of administration that is customary and least invasive method to treat the condition. There are several ways to administer drugs into the body including:  • inhalation (into the lungs, usually through the mouth);  • intramuscular (injected into a muscle);  • intra-articular (injected into a skeletal joint space);  • intrathecal (injected into the space around the spinal cord);  • intravenous/infused/intra-arterial (into a vein or artery);  • nasal (sprayed into the nose);  • ocular (instilled in the eye);  • oral (by mouth);  • rectal or vaginal (inserted into the rectum or vagina);  • subcutaneous (injected beneath the skin);  • sublingual (under the tongue);  • topical (applied to the skin); OR  or • transdermal (delivered through the skin by a patch). The prescription drug is included in our allowance for the medical service being rendered. If the sole service is drug dispensing, the prescription drug is NOT covered. We use the term injected to include prescription drugs approved by us given by intra muscular or subcutaneous injection or in the case of a body cavity by instillation. See the Summary of Medical Benefits for benefit limits and the amount that you pay. See Prevention Preventive Care Services and Early Detection Services section for immunization and vaccination coverage information. We use the term infused to include those prescription drugs approved by us and administered into a vein or into an artery whether by mixing in fluids and administering intravenously or into an artery, direct injection, or by use of a pump that accesses the vein or artery. See the Summary of Medical Benefits for benefit limits and the amount that you pay.

Inpatient. We cover inpatient drugs as a hospital service. See Glossary for Section 8.0 – definition of hospital services. Generic, preferred brand name, or non-preferred brand name prescription drugs Drugs are covered at different benefit levels depending upon the route of administration. Our allowance for services rendered by the facilities, agencies, and professional providers may include the cost of the prescription drugs administered and/or dispensed. We will determine coverage based upon the route of administration that is customary and least invasive method to treat the condition. There are several ways to administer drugs into the body including:  • inhalation (into the lungs, usually through the mouth);  • intramuscular (injected into a muscle);  intra-articular (injected into a skeletal joint space);  • intrathecal (injected into the space around the spinal cord);  • intravenous/infused/intra-arterial (into a vein or artery);  • nasal (sprayed into the nose);  • ocular (instilled in the eye);  • oral (by mouth);  • rectal or vaginal (inserted into the rectum or vagina);  • subcutaneous (injected beneath the skin);  • sublingual (under the tongue);  • topical (applied to the skin); OR  • transdermal (delivered through the skin by a patch). INHALATION, NASAL, OCULAR, ORAL, RECTAL OR VAGINAL, SUBLINGUAL, TOPICAL, AND TRANSDERMAL DRUGS: The prescription drug is included in our allowance for the medical service being rendered. If the sole service is drug dispensing, the prescription drug is NOT covered. INJECTED DRUGS: We use the term injected to include prescription drugs approved by us given by intra muscular or subcutaneous injection or in the case of a body cavity by instillation. See the Summary of Medical Benefits for benefit limits and the amount that you paylevel of coverage. See Prevention Section 3.30 Preventive Care Services and Early Detection Services section for immunization and vaccination coverage information. INFUSED DRUGS: We use the term infused to include those prescription drugs approved by us and administered into a vein or into an artery whether by mixing in fluids and administering intravenously or into an artery, direct injection, or by use of a pump that accesses the vein or artery. See the Summary of Medical Benefits for benefit limits and level of coverage. ANTI-NEOPLASTIC (CHEMOTHERAPY) DRUGS WHEN USED FOR CANCER TREATMENT: Oral, injectable, and infused anti-neoplastic prescription drugs approved by us for the amount treatment of cancer are covered. This includes coverage for drugs that you paywe designate as supportive, but not anti-neoplastic (e.g., anti-nausea drugs). See the Summary of Medical Benefits for benefit limits and level of coverage. ANTI-NEOPLASTIC (CHEMOTHERAPY) DRUGS WHEN USED FOR OTHER THAN CANCER TREATMENT: Coverage varies depending on the route of administration refer to above sections for inhalation, nasal, ocular, oral, rectal or vaginal, sublingual, topical and transdermal, injected and infused drugs.

Inpatient. We cover inpatient drugs as a hospital service. See Glossary for Section 8.0 – definition of hospital services. Outpatient/In Your Doctor’s Office/In Your Home Generic, preferred brand name, or non-preferred brand name prescription drugs are covered at different benefit levels depending upon the route of administration. Our allowance for services rendered by the facilities, agencies, and professional providers may include the cost of the prescription drugs administered and/or dispensed. We will determine coverage based upon the route of administration that is customary and least invasive method to treat the condition. There are several ways to administer drugs into the body including:  inhalation (into the lungs, usually through the mouth);  intramuscular (injected into a muscle);  intra-articular (injected into a skeletal joint space);  intrathecal (injected into the space around the spinal cord);  intravenous/infused/intra-arterial (into a vein or artery);  nasal (sprayed into the nose);  ocular (instilled in the eye);  oral (by mouth);  rectal or vaginal (inserted into the rectum or vagina);  subcutaneous (injected beneath the skin);  sublingual (under the tongue);  topical (applied to the skin); OR or  transdermal (delivered through the skin by a patch). The prescription drug is included in our allowance for the medical service being rendered. If the sole service is drug dispensing, the prescription drug is NOT covered. We use the term injected to include prescription drugs approved by us given by intra muscular or subcutaneous injection or in the case of a body cavity by instillation. See the Summary of Medical Benefits for benefit limits and the amount that you pay. See Prevention Section - 3.28 Preventive Care Services and Early Detection Services section for immunization and vaccination coverage information. We use the term infused to include those prescription drugs approved by us and administered into a vein or into an artery whether by mixing in fluids and administering intravenously or into an artery, direct injection, or by use of a pump that accesses the vein or artery. See the Summary of Medical Benefits for benefit limits and the amount that you pay.