Prescription Plans Sample Clauses

Prescription Plans. The County shall offer a prescription plan with a national network, included in the premium cost for all County medical plans. The following 3-tier formulary prescription plan will be included with the CIGNA OAP and OAPIN Medical plans Prescriptions filled at retail pharmacies – up to 34 day supply Prescriptions filled through Mail Order pharmacy – up to 102 day supply $5 copay for Generic Drug $10 copay for Generic Drug $20 copay for Brand Formulary Drug $40 copay for Brand Formulary Drug $35 copay for Brand non-Formulary Drug $70 copay for Brand non-Formulary Drug Prescriptions filled at retail pharmacies – up to 34 day supply Prescriptions filled through Mail Order pharmacy – up to 102 day supply $12 copay for Generic $24 copay for Generic Drug $30 copay for Brand Formulary Drug $60 copay for Brand Formulary Drug $45 copay for Brand non-Formulary Drug $90 copay for Brand non-Formulary Drug The County shall provide for the participation of the Health Care Review Committee in the review of the prescription plan formulary Network and Care Management utilized by the prescription plan administrator and periodic review of the formulary. Prescription plans shall be included with the medical plans.
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Prescription Plans. ‌ The County shall offer a prescription plan with a national network, included in the premium cost for all County medical plans. The following 3-tier formulary prescription plan will be included with the CIGNA OAP and OAPIN Medical plans Effective January 1, 2015‌ Prescriptions filled at retail pharmacies Prescriptions filled through Mail Order pharmacy-up to 34 day supply -up to 102 day supply $12 copay for Generic $24 copay for Generic Drug $30 copay for Brand Formulary Drug $60 copay for Brand Formulary Drug $45 copay for Brand non-Formulary Drug $90 copay for Brand non-Formulary Drug The County shall provide for the participation of the Health Care Review Committee in the review of the prescription plan formulary Network and Care Management utilized by the prescription plan administrator and periodic review of the formulary. Prescription plans shall be included with the medical plans.
Sample 1
Prescription Plans. The following pages provides you with a side by side comparison of your benefit options to assist you in making your decision. It is intended as an easy-to-read summary and provides a general overview of your benefits. The below is not a contract, additional limitations and exclusions may apply. Payment amounts are based on BCBSM’s approved amount, less any applicable deductible and/or copay. PLEASE REFER TO YOUR BCBSM BENEFIT SUMMARY FOR ADDITIONAL INFORMATION INCLUDING OUT-OF-NETWORK BENEFITS. Community Blue PPO BCBS 100/80% with $150/$300 deductible Community Blue PPO BCBS 100/80% with $1,000/$2,000 deductible Simply Blue PPO HSA $1,400/$2,800 Plan Individual $150 $1,000 $1,400 Family (two or more) $300 $2,000 $2,800* Copays Copays $10 copay for office visitsand office consultations $50 copay for emergencyroom visits $10 copay for office visitsand office consultations $50 copay for emergencyroom visits All services are subject to the deductible. See “Prescription Drugs” section for Rx copays Annual out-of-pocket $150 for one member, $300 for two or more members each calendar year $3,500 for one member $7,000 for two or more members each calendar year $2,250 for one person contract or $4,500 for two ormore members each calendar year maximums— applies to deductible, copays and coinsurance amounts for all covered services—including prescription drugcopays and coinsurance amounts, if applicable. *The full family deductible must be met under a two-person or family contract before benefits are paid for any person on the contract. Medical/Prescription Plans (Continued) Community Blue PPOBCBS 100/80% with $150/$300 deductible Community Blue PPOBCBS 100/80% with $1,000/$2,000 deductible Simply Blue PPO HSA $1,400/$2,800 Plan Health Maintenance Exam Covered 100% Covered 100% Covered 100% Annual Gynecological Exam Covered 100% Covered 100% Covered 100% Pap Smear Screening laboratory & pathology services Covered 100% Covered 100% Covered 100% Mammography Screening Covered 100% Covered 100% Covered 100% Well-baby and Child Care Covered 100% Covered 100% Covered 100% Immunizations Covered 100% Covered 100% Covered 100% Office Visit (Illness/Injury Related) including consultations and online visits $10 copay $10 copay 100% after in networkdeductible Ambulance Services (medically necessary) 100% after in network deductible 100% after in network deductible 100% after in network deductible Hospital Emergency room $50 copay (Waived if admitted or for anaccidental injury) ...
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Prescription Plans. The County shall offer a prescription plan with a national network, included in the premium cost for all County medical plans. The following 3-tier formulary prescription plan will be included with the Triple Option medical plan: 1. Effective September 1, 2007 – $75 person/year 2. Effective September 1, 2008 – $100 person/year The County shall provide for the participation of the Health Care Review Committee in the review of the prescription plan formulary utilized by the prescription plan administrator and periodic review of the formulary. Prescription plans shall be included with the HMO medical plans. Plan administration is determined by the respective HMO plan administrators.
Sample 1
Prescription Plans. The County shall offer a prescription plan with a national network, included in the premium cost for all County medical plans. The following 3-tier formulary prescription plan will be included with the CIGNA OAP and OAPIN Medical plans Prescriptions filled at retail pharmacies – up to 34 Prescriptions filled through Mail Order day supply pharmacy – up to 102 day supply $5 copay for Generic Drug $10 copay for Generic Drug $20 copay for Brand Formulary Drug $40 copay for Brand Formulary Drug $35 copay for Brand non-Formulary Drug $70 copay for Brand non-Formulary Drug Prescriptions filled at retail pharmacies – up to 34 Prescriptions filled through Mail Order day supply pharmacy – up to 102 day supply $12 copay for Generic $24 copay for Generic Drug $30 copay for Brand Formulary Drug $60 copay for Brand Formulary Drug $45 copay for Brand non-Formulary Drug $90 copay for Brand non-Formulary Drug Medicare Supplemental RX Deductible: Effective September 1, 2007 $75 person/year Effective September 1, 2008 $100 person/year The County shall provide for the participation of the Health Care Review Committee in the review of the prescription plan formulary Network and Care Management utilized by the prescription plan administrator and periodic review of the formulary. Prescription plans shall be included with the medical plans.
Sample 1
Prescription Plans. Xxxxxxxxx will reimburse National for prescription claims paid by National.
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Related to Prescription Plans

  • Specialty Prescription Drugs (+ Prorated copayments for a shorter supply period may apply for network pharmacy only. See Prescription Drug section for details. When purchased at a Specialty Pharmacy (+): For maintenance and non-maintenance prescription drugs, a copayment applies for each 30-day period (or portion thereof) within the prescribeddosing period. Tier 5: $125 Not Covered When purchased at a Retail Pharmacy (+): For maintenance and non-maintenance prescription drugs, a copayment applies for each 30-day period (or portion thereof) within the prescribeddosing period. Specialty Prescription Drugs purchasedat a retail pharmacy will require a significantly higher out of pocket expense than if purchased from a Specialty Pharmacy. Our reimbursement is based on the pharmacy allowance. Tier 5: 50% Not Covered When purchased at a Mail Order Pharmacy: Not Covered Not Covered Infertility Prescription Drugs - Three(3) in-vitro cycles will be covered per plan year with a total of eight (8) in-vitro cycles covered in a member’s lifetime. When purchased at a Specialty, Mail Order, or Retail Pharmacy Tier 1: 20% Not Covered Tier 2: 20% Not Covered Tier 3: 20% Not Covered Tier 4: 20% Not Covered When purchased at a Specialty Pharmacy (+) Tier 5: 20% Not Covered When purchased at a Retail Pharmacy (+): Specialty Prescription Drugs purchased at a retail pharmacy will require a significantly higher out of pocket expense than if purchased from a specialty pharmacy. Tier 5: 20% Not Covered Contraceptive Methods- Preventive Coverage includes barrier method (diaphragmor cervical cap), hormonal method (birth control pill), and emergency contraception. For non-preventive contraceptive prescription drugs and devices, the amount you pay will depend on the tier placement of the contraceptive prescription drug or device. See above for details. When purchased at a Retail Pharmacy: Up to a 365-day supply of contraceptive prescription drugs is available at all network retail pharmacies. For more information about this option, visit our website. Tier 1: $0 Not Covered When purchased at a Mail Order Pharmacy: Up to a 90-day supply. Tier 1: $0 Not Covered

  • Prescription Glasses This plan covers prescription glasses as follows: • Frames - one (1) collection frame per plan year; • Lenses - one (1) pair of glass or plastic collection lenses per plan year. This includes single vision, bifocal, trifocal, lenticular, and standard progressive lenses. This plan covers the following lens treatments: • UV treatment; • tint (fashion, gradient, and glass-grey); • standard plastic scratch coating; • standard polycarbonate; and • photocromatic/transitions plastic. This plan covers one (1) supply of contact lenses as follows: • conventional contact lenses - one (1) pair per plan year from a selection of • extended wear disposable lenses - up to a 6-month supply of monthly or two- week single vision spherical or toric disposable contact lenses per plan year; or • daily wear disposable lenses - up to a 3-month supply of daily single vision spherical disposable contact lenses per plan year. This plan also covers the evaluation, fitting, or follow-up care related to contact lenses. This plan covers additional contact lenses if your prescribing network provider submits a verification form, with the regular claim form, verifying that you have one of the following conditions: • anisometropia of 3D in meridian powers; • high ametropia exceeding -10D or +10D in meridian powers; • keratoconus when the member’s vision is not correctable to 20/25 in either or both eyes using standard spectacle lenses; and • vision improvement for members whose vision can be corrected two lines of improvement on the visual acuity chart when compared to the best corrected standard spectacle lenses.

  • Prescription Drugs The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types of treatments limit is preauthorization. Preauthorization is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. Mental disorders are covered under Section A. Mental Health Services. Substance abuse disorders are covered under

  • Meal Plans Residents living in Residence Facility are required to purchase a College meal plan. Information regarding the meal plan options can be found at xxx.xxx.xxx/xxxxxxx.

  • Prescription Claims against the Issuer or any Guarantor for the payment of principal or Additional Amounts, if any, on the Notes will be prescribed ten years after the applicable due date for payment thereof. Claims against the Issuer or any Guarantor for the payment of interest on the Notes will be prescribed five years after the applicable due date for payment of interest.