Designated Plan Pharmacy definition

Designated Plan Pharmacy means a pharmacy that has entered into an agreement with SHL to provide specific Covered Drugs and/or supplies to Insureds. The fact that a pharmacy is a Plan Pharmacy does not mean that it is a Designated Plan Pharmacy. For the purposes of the Prescription Drug Benefit, please refer to the SHL PDL on the website or contact Member Services for the specific Designated Plan Pharmacy for your Covered Drug and/or supply/equipment.
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Designated Plan Pharmacy means a pharmacy that has entered into an agreement with HPN to provide specific Covered Drugs and/or supplies to Members. The fact that a pharmacy is a Plan Pharmacy does not mean that it is a Designated Plan Pharmacy. For the purposes of the Prescription Drug Benefit Rider, please refer to the HPN PDL on the website or contact Member Services for the specific Designated Plan Pharmacy for your Covered Drug and/or supply/equipment.
Sample 1Sample 2Sample 3
Designated Plan Pharmacy means a pharmacy that has entered into an agreement with SHL to
Sample 1Sample 2Sample 3

Examples of Designated Plan Pharmacy in a sentence

  • If you choose not to use the Designated Plan Pharmacy and instead have the Specialty Covered Drugs dispensed by a non-Designated Plan Retail Pharmacy, you will be responsible for paying two times the amount of the Specialty Covered Drug Tier Copayment and/or Coinsurance as stated in the applicable plan Attachment A, Schedule of Benefits.

  • Benefits for Covered Drugs are payable subject to the following conditions:  A Designated Plan Pharmacy must dispense the Covered Drug, except as otherwise specifically provided herein.

  • If you require certain Covered Drugs, including, but not limited to, Specialty Drugs, HPN may direct you to a Designated Plan Pharmacy with whom HPN has an arrangement to provide those Covered Drugs.

  • Benefits for Covered Drugs obtained at a Designated Plan Pharmacy are payable according to the applicable benefit tiers described below, subject to the Member obtaining any required Prior Authorization or meeting any applicable Step Therapy requirement.

  • Benefits for Covered Drugs obtained at a Designated Plan Pharmacy are payable according to the applicable benefit tiers described below, subject to the Insured obtaining any required Prior Authorization or meeting any applicable Step Therapy requirement.

  • Benefits for Covered Drugs are payable subject to the following conditions: • A Designated Plan Pharmacy must dispense the Covered Drug, except as otherwise specifically provided herein.

  • After satisfying any applicable CYD, the Member will pay the applicable tier Copayment and/or Coinsurance plus the difference between the Eligible Medical Expenses (“EME”) of the Generic Covered Drug and the EME of the Brand Name Covered Drug to the Designated Plan Pharmacy for each Therapeutic Supply.

  • After satisfying any applicable CYD, the Insured will pay the applicable tier Copayment and/or Coinsurance plus the difference between the Eligible Medical Expenses (“EME”) of the Generic Covered Drug and the EME of the Brand Name Covered Drug to the Designated Plan Pharmacy for each Therapeutic Supply.

  • After satisfying any applicable CYD, the Member will pay the applicable tier Copayment and/or Coinsurance plus the difference between the Eligible Medical Expenses, or the Recognized Amount when applicable, of the Generic Covered Drug and of the Brand Name Covered Drug to the Designated Plan Pharmacy for each Therapeutic Supply.

  • After satisfying any applicable CYD, the Insured will pay the applicable tier Copayment and/or Coinsurance plus the difference between the Eligible Medical Expenses, or the Recognized Amount when applicable, of the Generic Covered Drug and of the Brand Name Covered Drug to the Designated Plan Pharmacy for each Therapeutic Supply.


More Definitions of Designated Plan Pharmacy

Designated Plan Pharmacy means a pharmacy that has entered into an agreement with HPN to provide specific Covered Drugs and/or supplies to Members. The fact that a pharmacy is a Plan Pharmacy does not mean that it is a Designated Plan Pharmacy. For the
Sample 1Sample 2Sample 3
Designated Plan Pharmacy means a pharmacy that has entered into an
Sample 1Sample 2
Designated Plan Pharmacy means a pharmacy that has entered into an agreement with HPN to provide specific Covered Drugs
Sample 1

Related to Designated Plan Pharmacy

  • Participating Retail Health Clinic means a Retail Health Clinic which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Participating Prescription Drug Provider means an independent retail Pharmacy, chain of retail Pharmacies, mail-order Pharmacy or specialty drug Pharmacy which has entered into an agreement to provide pharmaceutical services to participants in the benefit program. A retail Participating Pharmacy may or may not be a select Participating Pharmacy as that term is used in the Vaccinations Obtained Through Participating Pharmacies section.

  • Basic health plan model plan means a health plan as required in RCW 70.47.060(2)(e).

  • Participating Orthotic Provider means an Orthotic Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Participating Clinical Social Worker means a Clinical Social Worker who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Non-Participating Retail Health Clinic means a Retail Health Clinic which does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Educational program means a program for educating and preparing physician assistants which is approved by the board.

  • Participating Clinical Laboratory means a Clinical Laboratory which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Individualized Education Program (IEP means a written statement for a student with a disability that is developed, reviewed, and revised in accordance with the Utah Special Education Rules and Part B of the Individuals with Disabilities Education Act (IDEA).

  • Participating Prosthetic Provider means a Prosthetic Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Individualized education program or “IEP” means a written statement for a child with a disability as defined in 14 DE Admin. Code 922.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Basic health plan means the plan described under chapter