Common use of Prescription Drug Benefit Clause in Contracts

Prescription Drug Benefit. Faculty members electing any of the Medical Plan options will be covered under the current prescription drug benefit plan. Purchases are subject to a co-insurance payment from the employee, but are not subject to an annual deductible. 1. Prescription drug benefits for Faculty members electing any medical benefit plans shall also include coverage for oral contraceptives. 2. The prescription drug benefit provided to employees electing any of the medical plans will include the following features: a. Medications may be received from either a retail pharmacy or a mail service pharmacy subject to the limitations below. The maximum prescription available at a retail pharmacy is a 30-day supply; the maximum prescription available from the mail service pharmacy is a 90-day supply. b. Co-insurance levels will be 10% for generic medications, 20% for brand name medications and 40% for brand name medications when a generic equivalent is available. The maximum coinsurance for any single prescription will be $60, except when a brand name medication is prescribed when a generic equivalent is available. In this case, the maximum coinsurance for any single prescription will be $100, unless the physician has written the prescription dispense as written. c. Benefits will be provided for maintenance medications (whether brand or generic) through a retail pharmacy for a 30-day prescription and two 30-day refills at the retail level. After the initial 90-day period, benefits will be provided for maintenance medications through the mail service pharmacy only.

Prescription Drug Benefit. Faculty members electing any of the Medical Plan options medical plan will be covered under eligible to participate in the current prescription drug benefit planprogram. Purchases are subject to a co-insurance payment from the employee, but are not subject to an annual deductible. 1. Prescription drug benefits for Faculty members electing any medical benefit plans shall also include coverage for oral contraceptives. 2. The prescription drug benefit provided to employees electing any of the medical plans will include the following features: a. Medications may be received from either a retail pharmacy or a mail service pharmacy subject to the limitations below. The maximum prescription available at a retail pharmacy is a 30-day supply; the maximum prescription available from the mail service pharmacy is a 90-day supply. b. Co-insurance levels will be 10% for generic medications, 20% for brand name medications and 40% for brand name medications when a generic equivalent is available. The maximum coinsurance for any single prescription will be $60, except when a brand name medication is prescribed when a generic equivalent is available. In this case, the maximum coinsurance for any single prescription will be $100, unless the physician has written the prescription dispense as written. c. Benefits will be provided for maintenance medications (whether brand or generic) through a retail pharmacy for a 30-day prescription and two 30-day refills at the retail level. After the initial 90-day period, benefits will be provided for maintenance medications through the mail service pharmacy only.