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 Cost-share for up to a 30 day supply.  If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, SHL may direct you to a Designated Plan Pharmacy with whom 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.  When a Prescription Drug is packaged or designed to deliver in a manner that provides more than a consecutive thirty (30) day supply, the Cost-share that applies will reflect the number of days dispensed.

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 Cost-share for up to a 30 day supply.  • If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, SHL may direct you to a Designated Plan Pharmacy with whom 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.  • When a Prescription Drug is packaged or designed to deliver in a manner that provides more than a consecutive thirty (30) day supply, the Cost-share that applies will reflect the number of days dispensed.

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 Cost-share Copayment and/or Coinsurance for up to a 30 day supply.  If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, SHL may direct you to a Designated Plan Pharmacy with whom 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 tier as stated in the applicable plan Attachment A, Schedule of Benefits.  • When a Prescription Drug is packaged or designed to deliver in a manner that provides more than a consecutive thirty (30) day supply, the Cost-share that applies will reflect the number of days dispensed.

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 Cost-share Copayment and/or Coinsurance for up to a 30 thirty (30) day supply.  If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, SHL HPN may direct you to a Designated Plan Pharmacy with whom SHL HPN has an arrangement to provide those Covered Drugs. If you choose Agreement of Coverage 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.  • When a Prescription Drug is packaged or designed to deliver in a manner that provides more than a consecutive thirty (30) day supply, the Cost-share that applies will reflect the number of days dispensed.

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 Cost-share for up to a 30 day supply.  If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, SHL may direct you to a Designated Plan Pharmacy with whom 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.  When a Prescription Drug is packaged or designed to deliver in a manner that provides more than a consecutive thirty (30) day supply, the Cost-share that applies will reflect the number of days dispensed.

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 Cost-share Copayment and/or Coinsurance for up to a 30 thirty (30) day supply.  If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, SHL HPN may direct you to a Designated Plan Pharmacy with whom SHL 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.  • When a Prescription Drug is packaged or designed to deliver in a manner that provides more than a consecutive thirty (30) day supply, the Cost-share that applies will reflect the number of days dispensed.

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 Cost-share Copayment and/or Coinsurance for up to a 30 thirty (30) day supply.  If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, SHL HPN may direct you to a Designated Plan Pharmacy with whom SHL HPN has an arrangement to provide those Covered Drugs. If you choose Agreement of Coverage 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.  When a Prescription Drug is packaged or designed to deliver in a manner that provides more than a consecutive thirty (30) day supply, the Cost-share that applies will reflect the number of days dispensed.

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 Cost-share Copayment and/or Coinsurance for up to a 30 thirty (30) day supply.  If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, SHL HPN may direct you to a Designated Plan Pharmacy with whom SHL 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.  When a Prescription Drug is packaged or designed to deliver in a manner that provides more than a consecutive thirty (30) day supply, the Cost-share that applies will reflect the number of days dispensed.