Retail Pharmacy Network Sample Clauses
The Retail Pharmacy Network clause defines the group of retail pharmacies that are authorized to dispense prescription medications under a specific health plan or pharmacy benefit arrangement. This clause typically outlines the criteria for inclusion in the network, such as licensing requirements, geographic coverage, and adherence to negotiated pricing or service standards. By clearly specifying which pharmacies are part of the network, the clause ensures that plan members know where they can fill prescriptions at covered rates, and it helps manage costs and service quality for both the plan sponsor and participants.
Retail Pharmacy Network. The Contractor shall establish and maintain a retail pharmacy network throughout the 50 United States, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam. The Contractor shall provide network retail pharmacy services in American Samoa and the Northern Mariana Islands when they become eligible. The Contractor’s retail pharmacy network shall meet the following four minimum access standards (see definitions (Access Standards)▇▇▇, Appendix B):
Retail Pharmacy Network. Both parties agree to offer a comprehensive network of retail pharmacies which shall provide access, in accordance with Benefit Program requirements, to Medicare Part D beneficiaries.
Retail Pharmacy Network. Caremark shall create and maintain a national network of Participating Pharmacies, which are independent contractors, and Participating Group selects Caremark’s national network of Participating Pharmacies as its retail network, to provide prescription drugs and related products and Services with respect to the Plan. Caremark shall:
(a) Require Participating Pharmacies to service Plan Participants during their normal business hours, in all applicable geographic areas;
(b) Provide information to Participating Pharmacies concerning drug interaction, safety edits, and generic substitution and therapeutic intervention programs;
(c) Direct Participating Pharmacies to collect all applicable Cost Shares or the lesser of co- payment or U&C from Plan Participants;
(d) Provide and maintain toll-free telephone access to Participating Pharmacies to address claim submission and clinical drug utilization review issues;
(e) Maintain a database of Participating Pharmacies so that Plan Participants and Participating Group may locate a Participating Pharmacy using Caremark’s website;
(f) Maintain a claims adjudication system to process payments of paper and electronic claims in accordance with the PDD; and
(g) Be solely responsible for payment to the Participating Pharmacies of the charge for prescriptions dispensed (exclusive of Cost Shares), provided that the foregoing shall not release Participating Group from any payment obligation to Caremark under this Agreement.
(h) As required by applicable federal, state or local law, Caremark shall not limit a Participating Pharmacy’s ability to disclose to a Plan Participant whether their Cost Share exceeds the retail price for a Covered Drug, or the availability of a more affordable alternative drug.
Retail Pharmacy Network. S2 The name of your pharmacy network is listed above. When you get a 90-day fill of covered drugs at a retail pharmacy, your network includes pharmacies that offer standard cost sharing and pharmacies that offer preferred cost sharing: you will pay a lower cost share at CVS Pharmacy retail locations for up to a 90-day fill of covered drugs compared to other network retail pharmacies. To find a network pharmacy, you can look in your Pharmacy Directory, visit our website (▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇), or call Customer Service (phone numbers are printed on your member ID card).
Retail Pharmacy Network. S2 The name of your pharmacy network is listed above. To find a network pharmacy, or find up‑to‑date information about our network pharmacies, please call Member Services at the number on the back of your member ID card or consult the online Pharmacy Directory at ▇▇▇▇▇▇▇▇▇.▇▇▇/▇▇▇▇▇▇▇▇▇. To find out which cost‑sharing tier your drug is in, look it up in the plan’s Drug List. If your covered drug costs less than the copayment amount listed in the chart, you will pay that lower price for the drug. You pay either the full price of the drug or the copayment amount, whichever is lower. Tier 1 Preferred Generic drugs You pay $2 You pay $2 You pay $2 You pay $4 You pay $4 Tier 2 Generic drugs You pay $10 You pay $10 You pay $10 You pay $20 You pay $20 Tier 3 Preferred Brand drugs You pay $40 You pay $40 You pay $40 You pay $80 You pay $80 Tier 4 Non‑Preferred Brand drugs You pay $75 You pay $75 You pay $75 You pay $150 You pay $150 Tier 5 Specialty drugs ‑ Includes high‑cost/unique brand and generic drugs You pay 25%, but not more than $350, for your drug You pay 25%, but not more than $350, for your drug You pay 25%, but not more than $350, for your drug Limited to one‑month supply Limited to one‑month supply You won't pay more than $35 for a one‑month supply or $105 for up to a three‑month supply of each covered insulin product regardless of the cost‑sharing tier. *Out‑of‑network coverage is limited to certain situations. See the Evidence of Coverage Chapter 5, Section
Retail Pharmacy Network