Common use of Six Month Dispensing Clause in Contracts

Six Month Dispensing. You are entitled to receive a six-month supply of contraceptives, if prescribed and self- administered, when dispensed at one time by your pharmacy. To receive this benefit, your provider must specifically prescribe the six-month supply. If you need to change your contraceptive method before the six-month supply runs out, you may do so without cost- sharing. You will not owe cost sharing for any related contraceptive counseling or side- effects management. Brand Name Drugs or Devices Your plan may exclude or apply cost sharing to a name-brand contraceptive if a generic or therapeutic equivalent is available within the same category of contraception. Please see the table of contraceptive categories above. Ask your provider about a possible equivalent. If your provider determines that a brand-name contraceptive is medically necessary, your provider may ask us to cover that contraceptive without cost-sharing. If we deny the request, you or your provider can submit a grievance to contest that denial.

Six Month Dispensing. You are entitled to receive a six-month supply of contraceptives, if prescribed and self- administered, when dispensed at one time by your pharmacy. To receive this benefit, your provider Provider must specifically prescribe the six-month supply. If you need to change your contraceptive method before the six-month supply runs out, you may do so without cost- sharingCost Sharing. You will not owe cost sharing Cost Sharing for any related contraceptive counseling or side- side-effects management. Brand Name Drugs Contraceptives or Devices Your plan may exclude or apply cost sharing to a name-brand contraceptive if a generic or therapeutic equivalent is available within the same category of contraception. Please see Refer to the table list of contraceptive categories above. Ask your provider Provider about a possible equivalent. If your provider Provider determines that a brand-name contraceptive is medically necessary, your provider Provider may ask us to cover that contraceptive without cost-sharingCost Sharing. If we deny the request, you or your provider Provider can submit a grievance to contest that denial.

Six Month Dispensing. You are entitled to receive a six-month supply of contraceptives, if prescribed and self- administered, when dispensed at one time by your pharmacy. To receive this benefit, your provider must specifically prescribe the six-month supply. If you need to change your contraceptive method before the six-month supply runs out, you may do so without cost- cost-sharing. You will not owe cost sharing for any related contraceptive counseling or side- side-effects management. Brand Name Drugs or Devices Your plan may exclude or apply cost sharing to a name-brand contraceptive if a generic or therapeutic equivalent is available within the same category of contraception. Please see Refer to the table list of contraceptive categories above. Ask your provider Provider about a possible equivalent. If your provider Provider determines that a brand-name contraceptive is medically necessary, your provider Provider may ask us to cover that contraceptive without cost-sharingCost Sharing. If we deny the request, you or your provider Provider can submit a grievance to contest that denial.

Six Month Dispensing. You are entitled to receive a six-month supply of contraceptives, if prescribed and self- administered, when dispensed at one time by your pharmacy. To receive this benefit, your provider must specifically prescribe the six-month supply. If you need to change your contraceptive method before the six-month supply runs out, you may do so without cost- cost-sharing. You will not owe cost sharing for any related contraceptive counseling or side- side-effects management. Brand Name Drugs or Devices Your plan may exclude or apply cost sharing to a name-brand contraceptive if a generic or therapeutic equivalent is available within the same category of contraception. Please see Refer to the table list of contraceptive categories methods above. Ask your provider Provider about a possible equivalent. If your provider Provider determines that a brand-name contraceptive is medically necessary, your provider Provider may ask us to cover that contraceptive without cost-sharingCost Sharing. If we deny the request, you or your provider Provider can submit a grievance to contest that denial.

Six Month Dispensing. You are entitled to receive a six-month supply of contraceptives, if prescribed and self- administered, when dispensed at one time by your pharmacy. To receive this benefit, your provider Provider must specifically prescribe the six-month supply. If you need to change your contraceptive method before the six-month supply runs out, you may do so without cost- sharingCost Sharing. You will not owe cost sharing for any related contraceptive counseling or side- side-effects management. Brand Name Drugs or Devices Your plan may exclude or apply cost sharing to a name-brand contraceptive if a generic or therapeutic equivalent is available within the same category of contraception. Please see Refer to the table list of contraceptive categories methods above. Ask your provider Provider about a possible equivalent. If your provider Provider determines that a brand-name contraceptive is medically necessary, your provider Provider may ask us to cover that contraceptive without cost-sharingCost Sharing. If we deny the request, you or your provider Provider can submit a grievance to contest that denial.

Six Month Dispensing. You are entitled to receive a six-month supply of contraceptives, if prescribed and self- administered, when dispensed at one time by your pharmacy. To receive this benefit, your provider Provider must specifically prescribe the six-month supply. If you need to change your contraceptive method before the six-month supply runs out, you may do so without cost- cost sharing. You will not owe cost sharing for any related contraceptive counseling or side- side-effects management. management.‌‌‌ Brand Name Drugs or Devices Your plan may exclude or apply cost sharing to a name-brand contraceptive if a generic or therapeutic equivalent is available within the same category of contraception. Please see Refer to the table list of contraceptive categories methods above. Ask your provider Provider about a possible equivalent. If your provider Provider determines that a brand-name contraceptive is medically necessary, your provider Provider may ask us to cover that contraceptive without cost-sharingCost Sharing. If we deny the request, you or your provider Provider can submit a grievance to contest that denial.