Examples of Drug Products in a sentence
If a Member purchases drugs or Prescription Drug Products at a Value Participating Pharmacy, a Participating Pharmacy, an Extended Supply Pharmacy or a mail-order Pharmacy approved by The Plan, and the Member’s identification card is presented at the time of purchase, the Member must pay for the Prescription Drug Product and the Participating Pharmacy will submit a claim for the cost of the covered prescription drug or Prescription Drug Product to The Plan’s Pharmacy Benefit Manager.
Benefit for Prescription Drug Products are available when the Prescription Drug Product meets the definition of a Covered Medical Expense.
Compound Drugs unless all of the ingredients are FDA-approved in the form in which they are used in the Compound Drug and as designated in the FDA’s Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations, require a prescription to dispense, and the compound medication is not essentially the same as an FDA-approved product from a drug manufacturer.
Benefits are available for refills of Prescription Drug Products only when dispensed as ordered by a Physician and only after¾ of the original Prescription Drug Product has been used.
If a Member purchases drugs or Prescription Drug Products at a nonparticipating Pharmacy, the Member must pay for the prescription at the time of dispensing and then within one year of the date of purchase submit a claim for the prescription drug on a form to The Plan’s Pharmacy Benefit Manager for reimbursement.