Common use of Medication Synchronization Clause in Contracts

Medication Synchronization. Medication Synchronization allows Members to refill all of their Prescriptions on the same day, eliminating the need for multiple trips to the Pharmacy each month. Prescriptions are filled for less than the normal prescribed day supply in order to align the refill date across multiple prescriptions, allowing all refills on the same day and time period. Daily cost share reduces the patient pay for the prescription that is less than the standard defined days supply. Exclusions may include drug products for acute therapy, unbreakable packages and controlled substances. This benefit has one or more exclusions as specified in the Exclusions Section. You have the option to purchase up to a 90-day supply of Prescription Drugs/Medications. Under the up to a 90-day at Retail Pharmacy benefit, Preferred Generic, Non-Preferred Generic, Preferred Brand and Non-Preferred Drugs can be obtained from an In-network Pharmacy. If you chose the 90 days at retail option, you will be charged on copayment per 30-day supply up to a maximum of a 90-day supply. You will be charged three applicable Copayments for up to a 90-day supply up to the maximum dosing recommended by the manufacturer/FDA. Some medications may qualify for third-party copayment assistance programs which could lower your out-of-pocket costs for those products. For any such medication where third-party copayment assistance is used (Discount Cards or Prescription Drug Savings Cards), the Member shall not receive credit toward their maximum out-of-pocket or deductible for any copayment or coinsurance amounts that are applied to a manufacturer coupon or rebate. Self-Administered Specialty Pharmaceuticals are self-administered, meaning they are administered by the patient, a family member or care-giver. Specialty Pharmaceuticals are often used to treat complex chronic, rare diseases and/or life- threatening conditions. Most Specialty Pharmaceuticals require Prior Authorization and must be obtained through the specialty pharmacy network. Specialty Pharmaceuticals are often high cost, typically greater than $600 for up to a 30-day supply. Specialty Pharmaceuticals are not available through the retail or mail order option and are limited to a 30-day supply. Certain Specialty Pharmaceuticals are limited to an initial fill up to a 15-day supply to ensure patients can tolerate the new medication. For a complete list of these drugs, please see the Specialty Pharmaceutical listing at xxxx://xxxx.xxx.xxx/idc/groups/public/documents/communication/pel_00000000.pdf. You can call our Presbyterian Customer Service Center, Monday through Friday, from 7 a.m. to 6 p.m. at (000) 000-0000 or 0-000-000-0000. Hearing impaired users may call TTY 711. A Medical Drug is any drug administered by a Health Care Professional and is typically given in the member's home, physician’s office, freestanding (ambulatory) infusion suite, or outpatient facility. Medical Drugs may require a Prior Authorization and some must be obtained through the specialty network. These drugs may be subject to a separate Copayment/Coinsurance to a maximum as outlined in your Summary of Benefits and Coverage. For a complete list of Medical Drugs to determine which require Prior Authorization please see the Presbyterian Pharmacy website at xxxx://xxxx.xxx.xxx/idc/groups/public/%40phs/%40php/documents/phscontent/pel_0005273 9.pdf.

Medication Synchronization. Medication Synchronization allows Members to refill all of their Prescriptions on the same day, eliminating the need for multiple trips to the Pharmacy each month. Prescriptions are filled for less than the normal prescribed day supply in order to align the refill date across multiple prescriptions, allowing all refills on the same day and time period. Daily cost share Cost Sharing reduces the patient pay for the prescription that is less than the standard defined days days’ supply. Exclusions may include drug products for acute therapy, unbreakable packages and controlled substances. This benefit has one or more exclusions as specified in the Exclusions Section. You have the option to purchase up to a 90-day supply of Prescription Drugs/Medications. Under the up to a 90-day at Retail Pharmacy benefit, Preferred Generic, Non-Preferred Generic, Preferred Brand and Non-Preferred Drugs can be obtained from an In-In- network Pharmacy. If you chose choose the 90 days at retail option, you will be charged on one copayment per 30-day supply up to a maximum of a 90-day supply. You will be charged three applicable Copayments for up to a 90-day supply up to the maximum dosing recommended by the manufacturer/FDA. Some medications may qualify for third-party copayment assistance programs which could lower your out-of-pocket costs for those products. For any such medication where third-party copayment assistance is used (Discount Cards or Prescription Drug Savings Cards), the Member shall not receive credit toward towards their maximum out-of-pocket or deductible for any copayment or coinsurance amounts that are applied to a manufacturer coupon or rebate. Self-Administered Specialty Pharmaceuticals are self-administered, meaning they are administered by the patient, a family member or care-givercaregiver. Specialty Pharmaceuticals are often used to treat complex chronic, rare diseases and/or life- life-threatening conditions. Most Specialty Pharmaceuticals require Prior Authorization and must be obtained through the specialty pharmacy network. Specialty Pharmaceuticals are often high cost, typically greater than $600 for up to a 30-day supply. Specialty Pharmaceuticals are not available through the retail or mail order option and are limited to a 30-day supply. Certain Specialty Pharmaceuticals are limited to an initial fill up to a 15-may have additional day supply to ensure patients can tolerate the new medicationlimitations. For a complete list of these drugs, please see the Specialty Pharmaceutical listing at xxxx://xxxx.xxx.xxx/idc/groups/public/documents/communication/pel_00000000.pdf. You can call contact our Presbyterian Customer Service Center, Monday through Friday, from 7 a.m. to 6 p.m. Center at (000) 000-0000 or 01-000800- 923-000-0000. 6980, Monday through Friday from 7 a.m. to 6 p.m. Hearing impaired users may call TTY 711. A Medical Drug is any drug administered by a Health Care Professional and is typically given in the member's home, physician’s office, freestanding (ambulatory) infusion suite, or outpatient facility. Medical Drugs may require a Prior Authorization and some must be obtained through the specialty network. These drugs may be subject to a separate Copayment/Coinsurance to a maximum as outlined in your Summary of Benefits and Coverage. For a complete list of Medical Drugs to determine which require Prior Authorization please see the Presbyterian Pharmacy website at xxxx://xxxx.xxx.xxx/idc/groups/public/%40phs/%40php/documents/phscontent/pel_0005273 9.pdf.

Medication Synchronization. Medication Synchronization allows Members to refill all of their Prescriptions on the same day, eliminating the need for multiple trips to the Pharmacy each month. Prescriptions are filled for less than the normal prescribed day supply in order to align the refill date across multiple prescriptions, allowing all refills on the same day and time period. Daily cost share Cost Sharing reduces the patient pay for the prescription that is less than the standard defined days days’ supply. Exclusions may include drug products for acute therapy, unbreakable packages and controlled substances. This benefit has one or more exclusions as specified in the Exclusions Section. Section You have the option to purchase up to a 90-day supply of Prescription Drugs/Medications. Under the up to a 90-day at Retail Pharmacy benefit, Preferred Generic, Non-Preferred Generic, Preferred Brand and Non-Preferred Drugs can be obtained from an In-network Pharmacy. If you chose choose the 90 90-days at retail option, you will be charged on one copayment per 30-day supply up to a maximum of a 90-day supply. You will be charged three applicable Copayments for up to a 90-day supply up to the maximum dosing recommended by the manufacturer/FDA. Some medications may qualify for third-party copayment assistance programs which could lower your out-of-pocket costs for those products. For any such medication where third-party copayment assistance is used (Discount Cards or Prescription Drug Savings Cards), the Member shall not receive credit toward their maximum out-of-pocket or deductible for any copayment or coinsurance amounts that are applied to a manufacturer coupon or rebate. Self-Administered Specialty Pharmaceuticals are self-administered, meaning they are administered by the patient, a family member or care-givercaregiver. Specialty Pharmaceuticals are often used to treat complex chronic, rare diseases and/or life- life-threatening conditions. Most Specialty Pharmaceuticals require Prior Authorization and must be obtained through the specialty pharmacy network. Specialty Pharmaceuticals are often high cost, typically greater than $600 for up to a 30-day supply. Specialty Pharmaceuticals are not available through the retail or mail order option and are limited to a 30-day supply. Certain Specialty Pharmaceuticals are limited to an initial fill up to a 15-may have additional day supply to ensure patients can tolerate the new medicationlimitations. For a complete list of these drugs, please see the Specialty Pharmaceutical listing at xxxx://xxxx.xxx.xxx/idc/groups/public/documents/communication/pel_00000000.pdf. You can call our Presbyterian Customer Service Center, Monday through Friday, from 7 a.m. to 6 p.m. at (000) 000-0000 or 0-000-000-0000. Hearing impaired users may call TTY 711. A Medical Drug is any drug administered by a Health Care Professional and is typically given in the member's home, physician’s office, freestanding (ambulatory) infusion suite, or outpatient facility. Medical Drugs may require a Prior Authorization and some must be obtained through the specialty network. These drugs may be subject to a separate Copayment/Coinsurance to a maximum as outlined in your Summary of Benefits and Coverage. For a complete list of Medical Drugs to determine which require Prior Authorization please see the Presbyterian Pharmacy website at xxxx://xxxx.xxx.xxx/idc/groups/public/%40phs/%40php/documents/phscontent/pel_0005273 9.pdf.

Medication Synchronization. Medication Synchronization allows Members to refill all of their Prescriptions on the same day, eliminating the need for multiple trips to the Pharmacy each month. Prescriptions are filled for less than the normal prescribed day supply in order to align the refill date across multiple prescriptions, allowing all refills on the same day and time period. Daily cost share Cost Sharing reduces the patient pay for the prescription that is less than the standard defined days day’s supply. Exclusions may include drug products for acute therapy, unbreakable packages and controlled substances. This benefit has one or more exclusions as specified in the Exclusions Section. Section You have the option to purchase up to a 90-day supply of Prescription Drugs/Medications. Under the up to a 90-day at Retail Pharmacy benefit, Preferred Generic, Non-Preferred Generic, Preferred Brand and Non-Preferred Drugs can be obtained from an In-network Pharmacy. If you chose choose the 90 90-days at retail option, you will be charged on one copayment per 30-day supply up to a maximum of a 90-day supply. You will be charged three applicable Copayments for up to a 90-day supply up to the maximum dosing recommended by the manufacturer/FDA. Some medications may qualify for third-party copayment assistance programs which could lower your out-of-pocket costs for those products. For any such medication where third-party copayment assistance is used (Discount Cards or Prescription Drug Savings Cards), the Member shall not receive credit toward their maximum out-of-pocket or deductible for any copayment or coinsurance amounts that are applied to a manufacturer coupon or rebate. Self-Administered Specialty Pharmaceuticals are self-administered, meaning they are administered by the patient, a family member or care-givercaregiver. Specialty Pharmaceuticals are often used to treat complex chronic, rare diseases and/or life- life-threatening conditions. Most Specialty Pharmaceuticals require Prior Authorization and must be obtained through the specialty pharmacy network. Specialty Pharmaceuticals are often high cost, typically greater than $600 for up to a 30-day supply. Specialty Pharmaceuticals are not available through the retail or mail order option and are limited to a 30-day supply. Certain Specialty Pharmaceuticals are limited to an initial fill up to a 15-may have additional day supply to ensure patients can tolerate the new medicationlimitations. For a complete list of these drugs, please see the Specialty Pharmaceutical listing at xxxx://xxxx.xxx.xxx/idc/groups/public/documents/communication/pel_00000000.pdf. You can call our Presbyterian Customer Service Center, Monday through Friday, from 7 a.m. to 6 p.m. at (000) 000-0000 or 0-000-000-0000. Hearing impaired users may call TTY 711. A Medical Drug is any drug administered by a Health Care Professional and is typically given in the member's home, physician’s office, freestanding (ambulatory) infusion suite, or outpatient facility. Medical Drugs may require a Prior Authorization and some must be obtained through the specialty network. These drugs may be subject to a separate Copayment/Coinsurance to a maximum as outlined in your Summary of Benefits and Coverage. For a complete list of Medical Drugs to determine which require Prior Authorization please see the Presbyterian Pharmacy website at xxxx://xxxx.xxx.xxx/idc/groups/public/%40phs/%40php/documents/phscontent/pel_0005273 9.pdf.

Medication Synchronization. Medication Synchronization allows Members to refill all of their Prescriptions on the same day, eliminating the need for multiple trips to the Pharmacy each month. Prescriptions are filled for less than the normal prescribed day supply in order to align the refill date across multiple prescriptions, allowing all refills on the same day and time period. Daily cost share reduces the patient pay for the prescription that is less than the standard defined days supply. Exclusions may include drug products for acute therapy, unbreakable packages and controlled substances. This benefit has one or more exclusions as specified in the Exclusions Section. You have the option to purchase up to a 90-day supply of Prescription Drugs/Medications. Under the up to a 90-day at Retail Pharmacy benefit, Preferred Generic, Non-Preferred Generic, Preferred Brand and Non-Preferred Drugs can be obtained from an In-network Pharmacy. If you chose the 90 days at retail option, you will be charged on copayment per 30-day supply up to a maximum of a 90-day supply. You will be charged three applicable Copayments for up to a 90-day supply up to the maximum dosing recommended by the manufacturer/FDA. Some medications may qualify for third-party copayment assistance programs which could lower your out-of-pocket costs for those products. For any such medication where third-party copayment assistance is used (Discount Cards or Prescription Drug Savings Cards), the Member shall not receive credit toward their maximum out-of-pocket or deductible for any copayment or coinsurance amounts that are applied to a manufacturer coupon or rebate. Self-Administered Specialty Pharmaceuticals are self-administered, meaning they are administered by the patient, a family member or care-giver. Specialty Pharmaceuticals are often used to treat complex chronic, rare diseases and/or life- threatening conditions. Most Specialty Pharmaceuticals require Prior Authorization and must be obtained through the specialty pharmacy network. Specialty Pharmaceuticals are often high cost, typically greater than $600 for up to a 30-day supply. Specialty Pharmaceuticals are not available through the retail or mail order option and are limited to a 30-day supply. Certain Specialty Pharmaceuticals are limited to an initial fill up to a 15-day supply to ensure patients can tolerate the new medication. For a complete list of these drugs, please see the Specialty Pharmaceutical listing at xxxx://xxxx.xxx.xxx/idc/groups/public/documents/communication/pel_00000000.pdf. You can call our Presbyterian Customer Service Center, Monday through Friday, from 7 a.m. to 6 p.m. at (000) 000-0000 or 0-000-000-0000. Hearing impaired users may call TTY 711. A Medical Drug is any drug administered by a Health Care Healthcare Professional and is typically given in the member's home, physician’s office, freestanding (ambulatory) infusion suite, or outpatient facility. Medical Drugs may require a Prior Authorization and some must be obtained through the specialty network. These drugs may be subject to a separate Copayment/Coinsurance to a maximum as outlined in your Summary of Benefits and Coverage. For a complete list of Medical Drugs to determine which require Prior Authorization please see the Presbyterian Pharmacy website at xxxx://xxxx.xxx.xxx/idc/groups/public/%40phs/%40php/documents/phscontent/pel_0005273 9.pdf.

Medication Synchronization. Medication Synchronization allows Members to refill all of their Prescriptions on the same day, eliminating the need for multiple trips to the Pharmacy each month. Prescriptions are filled for less than the normal prescribed day supply in order to align the refill date across multiple prescriptions, allowing all refills on the same day and time period. Daily cost share Cost Sharing reduces the patient pay for the prescription that is less than the standard defined days days’ supply. Exclusions may include drug products for acute therapy, unbreakable packages and controlled substances. This benefit has one or more exclusions as specified in the Exclusions Section. You have the option to purchase up to a 90-day supply of Prescription Drugs/Medications. Under the up to a 90-day at Retail Pharmacy benefit, Preferred Generic, Non-Preferred Generic, Preferred Brand and Non-Preferred Drugs can be obtained from an In-network Pharmacy. If you chose the 90 days at retail option, you will be charged on copayment per 30-day supply up to a maximum of a 90-day supply. You will be charged three applicable Copayments for up to a 90-day supply up to the maximum dosing recommended by the manufacturer/FDA. Some medications may qualify for third-party copayment assistance programs which could lower your out-of-pocket costs for those products. For any such medication where third-party copayment assistance is used (Discount Cards or Prescription Drug Savings Cards), the Member shall not receive credit toward their maximum out-of-pocket or deductible for any copayment or coinsurance amounts that are applied to a manufacturer coupon or rebate. Self-Administered Specialty Pharmaceuticals are self-administered, meaning they are administered by the patient, a family member or care-giver. Specialty Pharmaceuticals are often used to treat complex chronic, rare diseases and/or life- threatening conditions. Most Specialty Pharmaceuticals require Prior Authorization and must be obtained through the specialty pharmacy network. Specialty Pharmaceuticals are often high cost, typically greater than $600 for up to a 30-day supply. Specialty Pharmaceuticals are not available through the retail or mail order option and are limited to a 30-day supply. Certain Specialty Pharmaceuticals are limited to an initial fill up to a 15-may have additional day supply to ensure patients can tolerate the new medicationlimitations. For a complete list of these drugs, please see the Specialty Pharmaceutical listing at xxxx://xxxx.xxx.xxx/idc/groups/public/documents/communication/pel_00000000.pdf. You can call our Presbyterian Customer Service Center, Monday through Friday, from 7 a.m. to 6 p.m. at (000) 000-0000 or 0-000-000-0000. Hearing impaired users may call TTY 711. A Medical Drug is any drug administered by a Health Care Healthcare Professional and is typically given in the member's home, physician’s office, freestanding (ambulatory) infusion suite, or outpatient facility. Medical Drugs may require a Prior Authorization and some must be obtained through the specialty network. These drugs may be subject to a separate Copayment/Coinsurance to a maximum as outlined in your Summary of Benefits and Coverage. For a complete list of Medical Drugs to determine which require Prior Authorization please see the Presbyterian Pharmacy website at xxxx://xxxx.xxx.xxx/idc/groups/public/%40phs/%40php/documents/phscontent/pel_0005273 9.pdf.

Medication Synchronization. Medication Synchronization allows Members to refill all of their Prescriptions on the same day, eliminating the need for multiple trips to the Pharmacy each month. Prescriptions are filled for less than the normal prescribed day supply in order to align the refill date across multiple prescriptions, allowing all refills on the same day and time period. Daily cost share Cost Sharing reduces the patient pay for the prescription that is less than the standard defined days days’ supply. Exclusions may include drug products for acute therapy, unbreakable packages and controlled substances. This benefit has one or more exclusions as specified in the Exclusions Section. You have the option to purchase up to a 90-day supply of Prescription Drugs/Medications. Under the up to a 90-day at Retail Pharmacy benefit, Preferred Generic, Non-Preferred Generic, Preferred Brand and Non-Preferred Drugs can be obtained from an In-network Pharmacy. If you chose choose the 90 90-days at retail option, you will be charged on one copayment per 30-day supply up to a maximum of a 90-day supply. You will be charged three applicable Copayments for up to a 90-day supply up to the maximum dosing recommended by the manufacturer/FDA. Some medications may qualify for third-party copayment assistance programs which could lower your out-of-pocket costs for those products. For any such medication where third-party copayment assistance is used (Discount Cards or Prescription Drug Savings Cards), the Member shall not receive credit toward their maximum out-of-pocket or deductible for any copayment or coinsurance amounts that are applied to a manufacturer coupon or rebate. Self-Administered Specialty Pharmaceuticals are self-administered, meaning they are administered by the patient, a family member or care-givercaregiver. Specialty Pharmaceuticals are often used to treat complex chronic, rare diseases and/or life- life-threatening conditions. Most Specialty Pharmaceuticals require Prior Authorization and must be obtained through the specialty pharmacy network. Specialty Pharmaceuticals are often high cost, typically greater than $600 for up to a 30-day supply. Specialty Pharmaceuticals are not available through the retail or mail order option and are limited to a 30-day supply. Certain Specialty Pharmaceuticals are limited to an initial fill up to a 15-may have additional day supply to ensure patients can tolerate the new medicationlimitations. For a complete list of these drugs, please see the Specialty Pharmaceutical listing at xxxx://xxxx.xxx.xxx/idc/groups/public/documents/communication/pel_00000000.pdfxxxx://xxxx.xxx.xxx/idc/groups/public/documents/ communication/pel_00000000.pdf. You can call our Presbyterian Customer Service Center, Monday through Friday, from 7 a.m. to 6 p.m. at (000) 000-0000 or 0-000-000-0000. 0000 Hearing impaired users may call TTY 711. A Medical Drug is any drug administered by a Health Care Professional and is typically given in the member's home, physician’s office, freestanding (ambulatory) infusion suite, or outpatient facility. Medical Drugs may require a Prior Authorization and some must be obtained through the specialty network. These drugs may be subject to a separate Copayment/Coinsurance to a maximum as outlined in your Summary of Benefits and Coverage. For a complete list of Medical Drugs to determine which require Prior Authorization please see the Presbyterian Pharmacy website at xxxx://xxxx.xxx.xxx/idc/groups/public/%40phs/%40php/documents/phscontent/pel_0005273 9.pdf.