Outpatient Prescription Drugs. 1. Benefits are provided for Covered Medications appearing on the Formulary when prescribed by a Professional Provider in connection with a Covered Service, when purchased at a Participating Pharmacy Provider upon presentation of a valid Identification Card and when dispensed on or after the Member’s Effective Date for Outpatient use. Benefits for Covered Medications are provided in the amounts specified in SECTION SB - SCHEDULE OF BENEFITS of this Agreement. Coverage is provided for: a. Prescription Drugs, including Specialty Prescription Drugs, obtained from a retail Participating Pharmacy Provider or through a mail service program from a Designated Mail-Order Pharmacy Provider; and b. Selected Prescription Drugs within, but not limited to, the following drug classifications only when such drugs are Covered Medications and when dispensed through an Exclusive Pharmacy Provider: i) Oncology related therapies; ii) Interferons; iii) Agents for multiple sclerosis and neurological related therapies; iv) Antiarthritic therapies; v) Anticoagulants; vi) Hematinic agents; vii) Immunomodulators; and viii) Growth hormones. These selected Prescription Drugs may be ordered by a Physician or other health care Provider on behalf of the Member or the Member may submit the Prescription Order directly to the Exclusive Pharmacy Provider. In either situation, the Exclusive Pharmacy Provider will deliver the Prescription Drug to the Member
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Samples: Individual Comprehensive Major Medical Preferred Provider Subscription Agreement, Individual Comprehensive Major Medical Preferred Provider Subscription Agreement
Outpatient Prescription Drugs. 1. Benefits are provided for Covered Medications appearing on the Formulary when prescribed by a Professional Provider in connection with a Covered Service, when purchased at a Participating Pharmacy Provider upon presentation of a valid Identification Card and when dispensed on or after the Member’s Effective Date for Outpatient use. Benefits for Covered Medications are provided in the amounts specified in SECTION SB - SCHEDULE OF BENEFITS of this Agreement. Coverage is provided for:
a. Prescription Drugs, including Specialty Prescription Drugs, obtained from a retail Participating Pharmacy Provider or through a mail service program from a Designated Mail-Order Pharmacy Provider; and;
b. Selected Prescription Drugs within, but not limited to, the following drug classifications only when such drugs are Covered Medications and when dispensed through an Exclusive Pharmacy Provider:
i) Oncology related therapies; ii) Interferons;
iii) Agents for multiple sclerosis and neurological related therapies;
iv) Antiarthritic therapies;
v) Anticoagulants;
vi) Hematinic agents;
vii) Immunomodulators; and
viii) Growth hormones. These selected Prescription Drugs may be ordered by a Physician or other health care Provider on behalf of the Member Member, or the Member may submit the Prescription Order directly to the Exclusive Pharmacy Provider. In either situation, the Exclusive Pharmacy Provider will deliver the Prescription Drug to the Member.
Appears in 1 contract
Samples: Individual Comprehensive Major Medical Preferred Provider Subscription Agreement
Outpatient Prescription Drugs. 1. Benefits are provided for Covered Medications appearing on the Formulary when prescribed by a Professional Provider in connection with a Covered Service, when purchased at a Participating Pharmacy Provider upon presentation of a valid Identification Card and when dispensed on or after the Member’s Effective Date for Outpatient use. Benefits for Covered Medications are provided in the amounts specified in SECTION SB - SCHEDULE OF BENEFITS of this Agreement. Coverage is provided for:
a. Prescription Drugs, Drugs including Specialty Prescription Drugs, Drugs obtained from a retail Participating Pharmacy Provider or through a mail service program from a Designated Mail-Order Pharmacy Provider; and
b. Selected Prescription Drugs within, but not limited to, the following drug classifications only when such drugs are Covered Medications and when dispensed through an Exclusive Pharmacy Provider:
i) Oncology related therapies; ii) Interferons;
iii) Agents for multiple sclerosis and neurological related therapies;
iv) Antiarthritic therapies;
v) Anticoagulants;
vi) Hematinic agents;
vii) Immunomodulators; and
viii) Growth hormones. These selected Prescription Drugs may be ordered by a Physician or other health care Provider on behalf of the Member Member, or the Member may submit the Prescription Order directly to the Exclusive Pharmacy Provider. In either situation, the Exclusive Pharmacy Provider will deliver the Prescription Drug to the Member.
Appears in 1 contract
