PLAN PAYMENT AND MEMBER LIABILITY FOR COVERED MEDICATIONS Sample Clauses

PLAN PAYMENT AND MEMBER LIABILITY FOR COVERED MEDICATIONS. The Plan’s payment for Covered Medications purchased from a Participating Pharmacy Provider is the Coinsurance percentage as set forth in SECTION SB - SCHEDULE OF BENEFITS of this Agreement. Any remaining Coinsurance amount is the Member’s responsibility subject to the minimum and maximum Coinsurance amounts set forth in SECTION SB - SCHEDULE OF BENEFITS of this Agreement. Preventive Medications are exempt from any Deductible, Copayment and/or Coinsurance obligation. No benefits are payable for Covered Medications purchased from a Pharmacy Provider that is not a Network Provider. Coverage is not provided for Prescription Drugs and Over-the-Counter Drugs not appearing on the Formulary, unless an exception has been granted pursuant to the prescription drug exceptions process described in this Agreement.
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PLAN PAYMENT AND MEMBER LIABILITY FOR COVERED MEDICATIONS. The Plan’s payment for Covered Medications purchased from a Participating Pharmacy Provider is determined by first subtracting any Deductible liability from the Provider’s Allowable Price. The Coinsurance percentage as set forth in SECTION SB - SCHEDULE OF BENEFITS of this Agreement is then applied to that amount once the Deductible, if any, has been satisfied. Any remaining Coinsurance amount is the Member’s responsibility. The Member’s total liability for Covered Medications is the sum of any Deductible and Coinsurance obligations, if any. However, until the Member has satisfied their Deductible, the Participating Pharmacy Provider is entitled to collect from the Member 100% of the Provider’s Allowable Price for the Covered Medication at the time of purchase. Preventive Medications are exempt from any Deductible and/or Coinsurance obligation. No benefits are payable for Covered Medications purchased from a Pharmacy Provider that is not a Network Provider. Coverage is not provided for Prescription Drugs and Over-the-Counter Drugs not appearing on the Formulary, unless an exception has been granted pursuant to the prescription drug exceptions process described in the SECTION XX - XXXXX CARE MANAGEMENT SERVICES of this Agreement.
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PLAN PAYMENT AND MEMBER LIABILITY FOR COVERED MEDICATIONS. The Plan’s payment for Covered Medications purchased from a Participating Pharmacy Provider is the Coinsurance percentage of the Provider’s Allowable Price as set forth in SECTION SB - SCHEDULE OF BENEFITS of this Agreement. Any remaining Coinsurance amount is the Member’s responsibilitysubject to the minimum and maximum coinsurqnce amount set forth in the OUTPATIENT PRESCRIPTION DRUGS Paragraph in the COVERED SERVICES Subsection of SECTION SB - SCHEDULE OF BENEFITS of this Agreement. Preventive Medications are exempt from any Deductible, Copayment and/or Coinsurance obligation. No benefits are payable for Covered Medications purchased from an Out-of-Network Provider.
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PLAN PAYMENT AND MEMBER LIABILITY FOR COVERED MEDICATIONS. The Plan’s payment for Covered Medications purchased from a Participating Pharmacy Provider is the Coinsurance percentage as set forth as set forth in SECTION SB - SCHEDULE OF BENEFITS of this Agreement . Any remaining Coinsurance amount is the Member’s responsibility, subject to the minimum and maximum Coinsurance amounts set forth in SECTION SB - SCHEDULE OF BENEFITS. The Member’s total liability for Covered Medications is the sum of any Deductible and Coinsurance obligations, if any. Preventive Medications are exempt from any Deductible, Copayment and/or Coinsurance obligation. No benefits are payable for Covered Medications purchased from a Pharmacy Provider that is not a Network Provider.
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Related to PLAN PAYMENT AND MEMBER LIABILITY FOR COVERED MEDICATIONS

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