Medications Benefits Sample Clauses

Medications Benefits. Injectable medications, except Self-injectable Drugs eligible for coverage under the Prescription Drug Rider, are a Covered Benefit when an oral alternative drug is not available, unless specifically excluded as described in the Exclusions and Limitations section of this Certificate. Medications must be prescribed by a Provider licensed to prescribe federal legend prescription drugs or medicines, and pre-authorized by HMO. If the drug therapy treatment is approved for self-administration, the Member is required to obtain covered medications at an HMO Participating pharmacy designated to fill injectable prescriptions. Injectable drugs or medication used for the treatment of cancer or Human Immunodeficiency Virus (HIV) are covered when the off-label use of the drug has not been approved by the Food and Drug Administration (FDA) for that indication, provided that such drug is recognized for treatment of such indication in one of the standard reference compendia (the United States Pharmacopoeia Drug Information, the American Medical Association Drug Evaluations, or the American Hospital Formulary Service Drug Information) and the safety and effectiveness of use for this indication has been adequately demonstrated by at least one study published in a nationally recognized peer reviewed journal. HMO NC COC AMENDSI (03-04) AETNA HEALTH INC. (NORTH CAROLINA) HOME HEALTH CARE AMENDMENT Contract Holder Group Agreement Effective Date: January 1, 2013 The Aetna Health Inc. Certificate is hereby amended as follows:
Sample 1See All (4)
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Medications Benefits. Injectable medications, except Self-injectable Drugs eligible for coverage under the Prescription Drug Rider, are a Covered Benefit when an oral alternative drug is not available, unless specifically excluded as described in the Exclusions and Limitations section of this Certificate. Medications must be prescribed by a Provider licensed to prescribe federal legend prescription drugs or medicines, and pre-authorized by HMO. If the drug therapy treatment is approved for self-administration, the Member is required to obtain covered medications at an HMO Participating pharmacy designated to fill injectable prescriptions. Injectable drugs or medication used for the treatment of cancer or HIV are covered when the off-label use of the drug has not been approved by the FDA for that indication, provided that such drug is recognized for treatment of such indication in 1 of the standard reference compendia (the United States Pharmacopoeia Drug Information, the American Medical Association Drug Evaluations, or the American Hospital Formulary Service Drug Information) and the safety and effectiveness of use for this indication has been adequately demonstrated by at least 1 study published in a nationally recognized peer reviewed journal. AETNA HEALTH INC. (ILLINOIS) HOME HEALTH CARE AMENDMENT Contract Holder Group Agreement Effective Date: January 1, 2013 The Aetna Health Inc. Certificate is hereby amended as follows:
Sample 1
Medications Benefits. Injectable medications, except Self-injectable Drugs eligible for coverage under the Prescription Drug Rider, are a Covered Benefit when an oral alternative drug is not available, unless specifically excluded as described in the Exclusions and Limitations section of this Certificate. Medications must be prescribed by a Provider licensed to prescribe federal legend prescription drugs or medicines, and pre-authorized by HMO. If the drug therapy treatment is approved for self-administration, the Member is required to obtain covered medications at an HMO Participating pharmacy designated to fill injectable prescriptions. Injectable drugs or medication used for the treatment of cancer or HIV are covered when the off-label use of the drug has not been approved by the FDA for that indication, provided that such drug is recognized for treatment of such indication in 1 of the standard reference compendia (the United States Pharmacopoeia Drug Information, the American Medical Association Drug Evaluations, or the American Hospital Formulary Service Drug Information) and the safety and effectiveness of use for this indication has been adequately demonstrated by at least 1 study published in a nationally recognized peer reviewed journal.
Sample 1
Medications Benefits. Injectable medications, except Self-injectable Drugs eligible for coverage under the Prescription Drug Rider, are a Covered Benefit when an oral alternative drug is not available, unless specifically excluded as described in the Exclusions and Limitations section of this Certificate. Medications must be prescribed by a Provider licensed to prescribe federal legend prescription drugs or medicines, and pre-authorized by HMO. If the drug therapy treatment is approved for self-administration, the Member is required to obtain covered medications at an HMO Participating pharmacy designated to fill injectable prescriptions. Injectable drugs or medication used for the treatment of cancer or HIV are covered when the off-label use of the drug has not been approved by the FDA for that indication, provided that such drug is recognized for treatment of such indication in 1 of the standard reference compendia (the United States Pharmacopoeia Drug Information, the American Medical Association Drug Evaluations, or the American Hospital Formulary Service Drug Information) and the safety and effectiveness of use for this indication has been adequately demonstrated by at least 1 study published in a nationally recognized peer reviewed journal. AETNA HEALTH INC. (DISTRICT OF COLUMBIA) CERTIFICATE OF COVERAGE AND SCHEDULE OF BENEFITS AMENDMENT Contract Holder Group Agreement Effective Date: January 1, 2012 The Aetna Health Inc. Certificate is hereby amended as follows: • The eligibility rules for Covered Dependents in the Eligibility and Enrollment section of the Certificate and the Dependent Eligibility section of the Schedule of Benefits have been changed. A child will now be eligible to enroll if he or she is under 26 years of age. Any rule that they be a full-time student, not married or chiefly dependent upon the Subscriber for support will not apply. All other dependent eligibility rules still apply. If the Subscriber has a child that can now be enrolled, the Subscriber may contact Member Services for details. Covered Benefits for a Covered Dependent who is not capable of self-support due to mental or physical incapacity will be continued past the maximum age for a child. • Any overall plan Calendar Year; Contract Year; or Lifetime Maximum Benefits that are dollar maximums in the Schedule of Benefits no longer apply. All references to these overall plan dollar maximums that may appear in the Schedule of Benefits and Certificate, including any amendments or Riders, which ...
Sample 1

Related to Medications Benefits

  • Medical Benefits The Company shall reimburse the Employee for the cost of the Employee's group health, vision and dental plan coverage in effect until the end of the Termination Period. The Employee may use this payment, as well as any other payment made under this Section 6, for such continuation coverage or for any other purpose. To the extent the Employee pays the cost of such coverage, and the cost of such coverage is not deductible as a medical expense by the Employee, the Company shall "gross-up" the amount of such reimbursement for all taxes payable by the Employee on the amount of such reimbursement and the amount of such gross-up.

  • Health Benefits The method for determining the Employer bi-weekly contributions to the cost of employee health insurance programs under the Federal Employees Health Benefits Program (FEHBP) will be as follows:

  • Program Benefits Under the Probation Status, the Participating Contractor will be eligible for all contractor incentives, its customers will have access to financing offered through the Program, and income- eligible households will be eligible to receive Program incentives.

  • Sick Benefits 15.01 Eligible employees will receive Short Term Disability Benefits in accordance with the terms and conditions outlined in the STD Plan Text, a copy of which has been supplied to the Union. The STD plan forms part of this Collective Agreement.

  • Sponsorship Benefits 3.1 INREV agrees to grant the Sponsor the above chosen and described sponsorship benefits.

  • Public Benefits This Agreement provides assurances that the Public Benefits identified below will be achieved and developed in accordance with the Applicable Rules and Project Approvals and with the terms of this Agreement and subject to the City’s Reserved Powers. The Project will provide Public Benefits to the City, including without limitation:

  • Layoff Benefits All rights to which a certificated employee was entitled at the time of his/her layoff including unused accumulated sick leave and credits toward leave eligibility will be restored to the certificated employee upon his/her return to active employment, and the certificated employee will be placed upon the proper step of the salary schedule for the certificated employee's current position according to the certificated employee's experience and education.

  • Training Benefits In the event that the Employer should introduce new methods or machines which require new or greater skills than are possessed by employees under the present method of operation, such employees shall, at the expense of the Employer, be given a reasonable period of time, in the opinion of the Employer, during which they may perfect or acquire the skills necessitated by the new method of operation. There shall be no change in wage or salary rates during the training period of any such employee.

  • STAFF BENEFITS 7.1.1 The present staff benefits consisting of the University of Manitoba Pension Plan (1993), Group Term Life Insurance Plan, Group Term Dependent Insurance Plan, Accidental Death and Dismemberment (Basic), Accidental Death and Dismemberment (Voluntary), University of Manitoba Long-Term Disability Income Plan, Group Health Insurance Policy 20778 GH (including the Health Care Spending Account), Group Dental Plan Policy 67000, and the University Employee Assistance Program shall continue to cover eligible Members for the duration of this Agreement.

  • Workplace Safety Insurance Benefits (WSIB) Top Up Benefits If the employee is in a class of employees that, on August 31, 2012, was entitled to use unused sick leave credits for the purpose of topping up benefits received under the Workplace Safety and Insurance Act, 1997;

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