Common use of Obtaining Covered Drugs Clause in Contracts

Obtaining Covered Drugs. Benefits for Covered Drugs are payable subject to the following conditions:  A Designated Plan Pharmacy must dispense the Covered Drug, except as otherwise specifically provided herein.  A Generic Covered Drug will be dispensed when available, subject to the prescribing Provider’s “Dispense as written” requirements.  Benefits for Specialty Covered Drugs as defined herein are payable subject to the applicable tier Copayment and/or Coinsurance for up to a thirty (30) day supply. If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, HPN may direct you to a Designated Plan Pharmacy with whom HPN has an arrangement to provide those Covered Drugs. If you choose not to use the Designated Plan Pharmacy and instead have the Specialty Covered Drugs dispensed by a non-Designated Plan Retail Pharmacy, you will be responsible for paying two times the amount of the Specialty Covered Drug Tier Copayment and/or Coinsurance as stated in the applicable plan Attachment A, Schedule of Benefits.

Appears in 2 contracts

Samples: Myhpn Solutions Agreement of Coverage, Myhpn Solutions Agreement of Coverage

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Obtaining Covered Drugs. Benefits for Covered Drugs are payable subject to the following conditions:  A Designated Plan Pharmacy must dispense the Covered Drug, except as otherwise specifically provided herein.  A Generic Covered Drug will be dispensed when available, subject to the prescribing Provider’s “Dispense as written” requirements. Benefits for Specialty Covered Drugs as defined herein are payable subject to the applicable tier Copayment and/or Coinsurance Cost-share for up to a thirty (30) 30 day supply. Agreement of Coverage  If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, HPN SHL may direct you to a Designated Plan Pharmacy with whom HPN SHL has an arrangement to provide those Covered Drugs. If you choose not to use the Designated Plan Pharmacy and instead have the Specialty Covered Drugs dispensed by a non-Designated Plan Retail Pharmacy, you will be responsible for paying two times the amount of the Specialty Covered Drug Tier Copayment and/or Coinsurance as stated in the applicable plan Attachment A, Schedule of Benefits.

Appears in 1 contract

Samples: sierrahealthandlife.com

Obtaining Covered Drugs. Benefits for Covered Drugs are payable subject to the following conditions:  A Designated Plan Pharmacy must dispense the Covered Drug, except as otherwise specifically provided herein.  A Generic Covered Drug will be dispensed when available, subject to the prescribing Provider’s “Dispense as written” requirements.  Benefits for Specialty Covered Drugs as defined herein are payable subject to the applicable tier Copayment and/or Coinsurance for up to a thirty (30) 30 day supply. If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, HPN may direct you to a Designated Plan Pharmacy with whom HPN has an arrangement to provide those Covered Drugs. If you choose not to use the Designated Plan Pharmacy and instead have the Specialty Covered Drugs dispensed by a non-Designated Plan Retail Pharmacy, you will be responsible for paying two times the amount of the Specialty Covered Drug Tier Copayment and/or Coinsurance as stated in the applicable plan Attachment A, Schedule of Benefits.

Appears in 1 contract

Samples: Myhpn Solutions Agreement of Coverage

Obtaining Covered Drugs. Benefits for Covered Drugs are payable subject to the following conditions: A Designated Plan Pharmacy must dispense the Covered Drug, except as otherwise specifically provided herein. A Generic Covered Drug will be dispensed when available, subject to the prescribing Provider’s “Dispense as written” requirements. Benefits for Specialty Covered Drugs as defined herein are payable subject to the applicable tier Copayment and/or Coinsurance for up to a thirty (30) 30 day supply. If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, HPN may direct you to a Designated Plan Pharmacy with whom HPN has an arrangement to provide those Covered Drugs. If you choose not to use the Designated Plan Pharmacy and instead have the Specialty Covered Drugs dispensed by a non-Designated Plan Retail Pharmacy, you will be responsible for paying the two times the amount of the Specialty Covered Drug Tier Copayment and/or Coinsurance cost-share as stated in the applicable plan Attachment A, Schedule of Benefits.

Appears in 1 contract

Samples: Group Enrollment Agreement

Obtaining Covered Drugs. Benefits for Covered Drugs are payable subject to the following conditions:  A Designated Plan Pharmacy must dispense the Covered Drug, except as otherwise specifically provided herein.  A Generic Covered Drug will be dispensed when available, subject to the prescribing Provider’s “Dispense as written” requirements.  Benefits for Specialty Covered Drugs as defined herein are payable subject to the applicable tier Copayment and/or Coinsurance for up to a thirty (30) 30 day supply. If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, HPN SHL may direct you to a Designated Plan Pharmacy with whom HPN SHL has an arrangement to provide those Covered Drugs. If you choose not to use the Designated Plan Pharmacy and instead have the Specialty Covered Drugs dispensed by a non-Designated Plan Retail Pharmacy, you will be responsible for paying two times the amount of the Specialty Covered Drug Tier Copayment and/or Coinsurance as stated in the applicable plan Attachment A, Schedule of Benefits.

Appears in 1 contract

Samples: sierrahealthandlife.com

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Obtaining Covered Drugs. Benefits for Covered Drugs are payable subject to the following conditions:  A Designated Plan Pharmacy must dispense the Covered Drug, except as otherwise specifically provided herein.  A Generic Covered Drug will be dispensed when available, subject to the prescribing Provider’s “Dispense as written” requirements.  Benefits for Specialty Covered Drugs as defined herein are payable subject to the applicable tier Copayment and/or Coinsurance for up to a thirty (30) 30 day supply. If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, HPN may direct you to a Designated Plan Pharmacy with whom HPN has an arrangement to provide those Covered Drugs. If you choose not to use the Designated Plan Pharmacy and instead have the Specialty Covered Drugs dispensed by a non-Designated Plan Retail Pharmacy, you will be responsible for paying the two times the amount of the Specialty Covered Drug Tier Copayment and/or Coinsurance cost-share as stated in the applicable plan Attachment A, Schedule of Benefits.

Appears in 1 contract

Samples: Group Enrollment Agreement

Obtaining Covered Drugs. Benefits for Covered Drugs are payable subject to the following conditions: A Designated Plan Pharmacy must dispense the Covered Drug, except as otherwise specifically provided herein. A Generic Covered Drug will be dispensed when available, subject to the prescribing Provider’s “Dispense as written” requirements. Benefits for Specialty Covered Drugs as defined herein are payable subject to the applicable tier Copayment and/or Coinsurance Cost-share for up to a thirty (30) 30 day supply. If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, HPN SHL may direct you to a Designated Plan Pharmacy with whom HPN SHL has an arrangement to provide those Covered Drugs. If you choose not to use the Designated Plan Pharmacy and instead have the Specialty Covered Drugs dispensed by a non-Designated Plan Retail Pharmacy, you will be responsible for paying two times the amount of the Specialty Covered Drug Tier Copayment and/or Coinsurance as stated in the applicable plan Attachment A, Schedule of Benefits.

Appears in 1 contract

Samples: sierrahealthandlife.com

Obtaining Covered Drugs. Benefits for Covered Drugs are payable subject to the following conditions: A Designated Plan Pharmacy must dispense the Covered Drug, except as otherwise specifically provided herein. A Generic Covered Drug will be dispensed when available, subject to the prescribing Provider’s “Dispense as written” requirements. Benefits for Specialty Covered Drugs as defined herein are payable subject to the applicable tier Copayment and/or Coinsurance for up to a thirty (30) day supply. If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, HPN may direct you to a Designated Plan Pharmacy with whom HPN has an arrangement to provide those Covered Drugs. If you choose not to use the Designated Plan Pharmacy and instead have the Specialty Covered Drugs dispensed by a non-Designated Plan Retail Pharmacy, you will be responsible for paying two times the amount of the Specialty Covered Drug Tier Copayment and/or Coinsurance as stated in the applicable plan Attachment A, Schedule of Benefits.

Appears in 1 contract

Samples: Myhpn Solutions Agreement of Coverage

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