Non-Plan Pharmacy Benefit Payments. In order for claims for Covered Drugs obtained at a Non-Plan Pharmacy to be eligible for benefit payment, the Member must complete and submit a Pharmacy Reimbursement Claim Form with the prescription label and register receipt to HPN or its designee. Benefit payments are subject to the limitations and exclusions set forth in the HPN AOC as follows:
Appears in 5 contracts
Samples: Myhpn Solutions Agreement of Coverage, Myhpn Solutions Agreement of Coverage, Myhpn Solutions Agreement of Coverage
Non-Plan Pharmacy Benefit Payments. In order for claims for Covered Drugs obtained at a Non-Plan Pharmacy to be eligible for benefit payment, the Member must complete and submit a Pharmacy Reimbursement Claim Form with the prescription label and register receipt to HPN or its designee. Benefit payments are subject to the limitations and exclusions set forth in the HPN AOC EOC as follows:
Appears in 1 contract
Samples: Group Enrollment Agreement
