Insulin for Diabetes Cost Sharing Cap. The Copayment amount for a preferred Formulary prescription insulin drug or a Medically Necessary alternative will be Covered at an amount not to exceed a total of $25.00* per 30-day supply. *Copayments are subject to Deductible first.
Appears in 3 contracts
Samples: Group Subscriber Agreement, Group Subscriber Agreement, Group Subscriber Agreement
Insulin for Diabetes Cost Sharing Cap. The Copayment amount for a preferred Formulary prescription insulin drug or a Medically Necessary alternative will be Covered at an amount not to exceed a total of $25.00* 25.00 per 30-day supply. *Copayments are subject to Deductible first.
Appears in 2 contracts
