Initial Coverage definition

Initial Coverage. Stage: Amount you pay, up to $4,430 in total covered prescription drug expenses. Standard Cost Share: The chart below lists the amount that you pay at a pharmacy that offers standard cost-sharing: Initial Coverage One-Month Supply Extended Supply Standard retail cost- sharing (in- network) (up to a 30-day supply) Long- term care (LTC) cost- sharing (up to a 31- day supply) Out-of- network cost- sharing* (up to a 30-day supply) Standard retail or standard mail order cost- sharing (up to a 90- day supply) Preferred mail order cost- sharing (up to a 90- day supply) Tier 1 Generic drugs You pay $10 You pay $10 You pay $10 You pay $30 You pay $20 Tier 2 Preferred brand drugs You pay a minimum of 25% or $10, whichever is greater, but not more than $50 for your drug You pay a minimum of 25% or $10, whichever is greater, but not more than $50 for your drug You pay a minimum of 25% or $10, whichever is greater, but not more than $50 for your drug You pay a minimum of 25% or $30, whichever is greater, but not more than $150 for your drug You pay a minimum of 25% or $20, whichever is greater, but not more than $100 for your drug Tier 3 Non-preferred brand drugs You pay a minimum of 25% or $25, whichever is greater, but not more than $100 for your drug You pay a minimum of 25% or $25, whichever is greater, but not more than $100 for your drug You pay a minimum of 25% or $25, whichever is greater, but not more than $100 for your drug You pay a minimum of 25% or $75, whichever is greater, but not more than $300 for your drug You pay a minimum of 25% or $50, whichever is greater, but not more than $200 for your drug Initial Coverage One-Month Supply Extended Supply Standard Long- Out-of- retail term care network cost- (LTC) cost- sharing cost- sharing* (in- sharing (up to a network) (up to a 31- 30-day (up to a day supply) 30-day supply) supply) Standard Preferred retail or mail standard mail order cost- order cost- sharing sharing (up to a 90- (up to a 90- day supply) day supply) Tier 4 Specialty drugs - Includes high- cost/unique brand and generic drugs You pay a minimum of 25% or $25, whichever is greater, but not more than $100 for your drug You pay a minimum of 25% or $25, whichever is greater, but not more than $100 for your drug You pay a minimum of 25% or $25, whichever is greater, but not more than $100 for your drug You pay a minimum of 25% or $75, whichever is greater, but not more than $300 for your drug You pay a minimum of 25% or $50, whichever is greater, ...
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Initial Coverage. Stage: Amount you pay, up to $4,430 in total covered prescription drug expenses. One-Month Supply Extended Supply Initial Coverage Standard retail cost- sharing (in- network) (up to a 30-day Long- term care (LTC) cost- sharing (up to a 31- day supply) Out-of- network cost- sharing* (up to a 30-day supply) Standard retail or standard mail order cost- sharing (up to a 90- day supply) Preferred mail order cost- sharing (up to a 90- day supply) supply) Tier 1 You pay You pay You pay You pay $0 You pay $0 Generic drugs $10 $10 $10 Tier 2 Preferred brand drugs You pay $20 You pay $20 You pay $20 You pay $40 You pay $40 Tier 3 Non-preferred brand drugs You pay $35 You pay $35 You pay $35 You pay $70 You pay $70 Tier 4 Specialty drugs - Includes high- cost/unique brand You pay $35 You pay $35 You pay $35 Limited to one-month supply Limited to one-month supply and generic drugs *Out-of-network coverage is limited to certain situations. See the Evidence of Coverage Chapter 5, Section 2.5 (Using the plan’s coverage for your Part D prescription drugs, When can you use a pharmacy that is not in the plan's network?) for information. Coverage Gap Stage: Amount you pay after you reach $4,430 in total covered prescription drug expenses and until you reach $7,050 in out-of-pocket covered prescription drug costs. Your plan’s gap coverage is listed in the chart below. Supplemental Gap Coverage One-Month Supply Extended Supply Standard Long- Out-of- retail term care network cost- (LTC) cost- sharing cost- sharing* (in- sharing (up to a network) (up to a 31- 30-day (up to a day supply) 30-day supply) supply) Standard Preferred retail or mail standard mail order cost- order cost- sharing sharing (up to a 90- (up to a 90- day supply) day supply) Tier 1 Generic drugs You pay $10 You pay $10 You pay $10 You pay $0 You pay $0 Tier 2 Preferred brand drugs You pay $20 You pay $20 You pay $20 You pay $40 You pay $40 Tier 3 Non-preferred brand drugs You pay $35 You pay $35 You pay $35 You pay $70 You pay $70 Tier 4 Specialty drugs - Includes high- cost/unique brand and generic drugs You pay $35 You pay $35 You pay $35 Limited to one-month supply Limited to one-month supply *Out-of-network coverage is limited to certain situations. See the Evidence of Coverage Chapter 5, Section 2.5 (Using the plan’s coverage for your Part D prescription drugs, When can you use a pharmacy that is not in the plan's network?) for information. Your former employer/union/trust provides additional coverage du...
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Initial Coverage. Stage: Amount you pay, up to $4,430 in total covered prescription drug expenses. Standard Cost Share: The chart below lists the amount that you pay at a pharmacy that offers standard cost-sharing: Initial Coverage One-Month Supply Extended Supply Standard retail cost- sharing (in- network) (up to a 30-day supply) Long- term care (LTC) cost- sharing (up to a 31- day supply) Out-of- network cost- sharing* (up to a 30-day supply) Standard retail or standard mail order cost- sharing (up to a 90- day supply) Preferred mail order cost- sharing (up to a 90- day supply) Tier 1 Generic drugs You pay $10 You pay $10 You pay $10 You pay $30 You pay $25 Tier 2 Preferred brand drugs You pay $10 You pay $10 You pay $10 You pay $30 You pay $25 Tier 3 Non-preferred brand drugs You pay $40 You pay $40 You pay $40 You pay $120 You pay $100 Tier 4 Specialty drugs - Includes high- cost/unique brand and generic drugs You pay $40 You pay $40 You pay $40 Limited to one-month supply Limited to one-month supply *Out-of-network coverage is limited to certain situations. See the Evidence of Coverage Chapter 5, Section 2.5 (Using the plan’s coverage for your Part D prescription drugs, When can you use a pharmacy that is not in the plan's network?) for information.
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Examples of Initial Coverage in a sentence

  • You begin in the Initial Coverage Stage when you fill your first prescription of the year.

  • During the Initial Coverage Stage, the plan pays its share of the cost of your covered prescription drugs, and you pay your share (your copayment or coinsurance amount).

  • During the Initial Coverage Stage, the plan pays its share of your drug costs, and you pay your share .

  • See Section 5 for information about your coverage in the Initial Coverage Stage.

  • If you do reach this amount, you will leave the Initial Coverage Stage and move on to the Coverage Gap Stage.

  • You can also contact Customer Service for more information.Changes to Prescription Drug CostsNote: If you are in a program that helps pay for your drugs (“Extra Help”), the information about costs for Part D prescription drugs may not apply to you.There are four “drug payment stages.”The information below shows the changes for next year to the first two stages – the Yearly Deductible Stage and the Initial Coverage Stage.

  • You will pay a maximum of $35 for a 1-month supply of Part D select insulin drugs during the deductible, Initial Coverage and Coverage Gap or "Donut Hole" stages of your benefit.

  • If you receive “Extra Help” and didn’t receive this insert with this packet, please call Customer Service and ask for the “LIS Rider.”There are four “drug payment stages.”The information below shows the changes to the first two stages — the Yearly Deductible Stage and the Initial Coverage Stage.

  • If you don’t receive it, please call Customer Service and ask for the "LIS Rider" to be sent to you.There are four “drug payment stages.” How much you pay for a Part D drug depends on which drug payment stage you are in.The information below shows the changes for next year to the first two stages – the Yearly Deductible Stage and the Initial Coverage Stage.

  • The amount you pay depends on the drug's tier and whether you are in the Deductible (if any), Initial Coverage, Coverage Gap, or Catastrophic Coverage Stage.


More Definitions of Initial Coverage

Initial Coverage has the meaning given in paragraph 1.3 of Schedule 7;
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Related to Initial Coverage

  • Initial Covered Debt means the Corporation’s 6.25% Notes due 2036, CUSIP No. 000000XX0.

  • Minimum Essential Coverage has the meaning given in the Affordable Care Act, 26 U.S.C. §5000A(f).

  • Debt Service Coverage means that for every $1.00 of debt service required to be paid there must be $1.15 of Net Operating Income available. A worksheet for the calculation of Debt Service Coverage is found in the Report of Operations attached hereto as Exhibit "H" and incorporated herein by this reference.

  • Collateral Coverage Ratio means (i) the aggregate value of any relevant collateral security, including the pro rata value of any shared collateral, divided by (ii) the outstanding aggregate principal amount of the relevant debt.

  • Effective Date of Coverage means the date of commencement of Coverage in respect of a Life Insured under the Policy pursuant to the provision on Commencement of Coverage.

  • Period of Coverage means the Plan Year, with the following exceptions: (a) for Employees who first become eligible to participate, it shall mean the portion of the Plan Year following the date on which participation commences, as described in Section 3.1; and (b) for Employees who terminate participation, it shall mean the portion of the Plan Year prior to the date on which participation terminates, as described in Section 3.2.

  • Creditable coverage means, with respect to an individual, coverage of the individual provided under any of the following:

  • Insurance Coverage Contractor shall, at Contractor’s sole expense, procure, maintain and keep in force for the duration of this Contract the following insurance conforming to the minimum requirements specified below. Unless specified herein or otherwise agreed to by the City, the required insurance shall be in effect prior to the commencement of work by Contractor and shall continue in force as appropriate until the latter of:

  • Lot coverage means the portion or percentage of the area of a lot upon which buildings are erected.

  • Environmental covenant means a servitude arising under an environmental response project that imposes activity and use limitations.

  • Asset Coverage Test is met if the Adjusted Aggregate Asset Amount (as defined below) shall be in an amount at least equal to the Canadian Dollar Equivalent of the aggregate Principal Amount Outstanding of the Covered Bonds as calculated on the relevant Calculation Date. For greater certainty, references in this Schedule to “immediately preceding Calculation Date” and “previous Calculation Date” are to the Calculation Period ending on the Calculation Date.

  • Class C Coverage Tests means the Class C Interest Coverage Test and the Class C Par Value Test.

  • Site Coverage means ratio expressed in percentage between the area covered by the ground floor of building and the area of the site;

  • Debt service extension base means an amount equal to that

  • Debt Service Coverage Ratio means a ratio for the applicable period in which:

  • Class A/B Coverage Tests means the Class A/B Interest Coverage Test and the Class A/B Par Value Test.

  • Optional Extended Local Calling Scope Arrangement Traffic is traffic that under an optional Extended Local Calling Scope Arrangement chosen by the Customer terminates outside of the Customer’s basic exchange serving area.

  • Coverage Area means the area described in the Website for which Nearmap has available Products, which may cover part or all of that area and which may cover part (but not all) of the area covered by the Survey.

  • Additional Covenant means any covenant in respect of the financial condition or financial position of the Company, including, but not limited to, covenants that specify or require the maintenance of certain financial ratios applicable to the Company, and the default provision related thereto (regardless of whether such provision is labeled or otherwise characterized as a covenant or a default).

  • Minimum Balance Requirements You must maintain a minimum daily balance of $2,000.00 in your Money Market Savings account to obtain the disclosed annual percentage yield. We impose a monthly maintenance fee if the balance falls below $500 any day of the month. Basic Checking Account Rate Information: This account does not pay interest.

  • Asset Coverage means asset coverage, as determined in accordance with Section 18(h) of the 1940 Act, of at least 200% with respect to all outstanding senior securities of the Fund which are stock, including all Outstanding Series A Preferred Shares (or such other asset coverage as may in the future be specified in or under the 1940 Act as the minimum asset coverage for senior securities which are stock of a closed-end investment company as a condition of declaring dividends on its common stock), determined on the basis of values calculated as of a time within 48 hours (not including Saturdays, Sundays or holidays) next preceding the time of such determination.

  • Initial compliance period means the first full three-year compliance period which begins at least 18 months after promulgation, except for the following contaminants: Dichloromethane; 1,2,4-Trichlorobenzene; 1,1,2- Trichloroethane; Benzo[a]pyrene; Dalapon; Di(2-ethylhexyl adipate; Di(2-ethylhexyl) phthalate; Dinoseb; Diquat; Endothall; Endrin; Glyphosate; Hexachlorobenzene; Hexachlorocyclopentadiene; Oxamyl (Vydate); Picloram; Simazine; 2,3,7,8-TCDD (Dioxin); Antimony; Beryllium; Cyanide; Nickel; and Thallium, initial compliance period means the first full three-year compliance period after promulgation for systems with 150 or more service connections (January 1993 -December 1995) and first full three-year compliance period after the effective date of regulation (January 1996 - December 1998) for systems having fewer than 150 service connections.

  • EBITDA Coverage Ratio defined as EBITDA divided by the aggregate of total interest expense plus the prior period current maturity of long-term debt and the prior period current maturity of subordinated debt.

  • Insurance Cost Increase shall not, however, include any premium increases resulting from the nature of the occupancy of any other lessee of the Building. If the parties insert a dollar amount in Paragraph 1.9, such amount shall be considered the "BASE PREMIUM." If a dollar amount has not been inserted in Paragraph 1.9 and if the Building has been previously occupied during the twelve (12) month period immediately preceding the Commencement Date, the "Base Premium" shall be the annual premium applicable to such twelve (12) month period. If the Building was not fully occupied during such twelve (12) month period, the "Base Premium" shall be the lowest annual premium reasonably obtainable for the Required Insurance as of the Commencement Date, assuming the most nominal use possible of the Building. In no event, however, shall Lessee be responsible for any portion of the premium cost attributable to liability insurance coverage in excess of $1,000,000 procured under Paragraph 8.2(b).

  • Standard Amendment Coversheet refers to the form used by the Judicial Council to amend agreements with other parties. Several originally signed, fully executed versions of a Standard Amendment, together with the integrated Contract Documents, shall each represent an Amendment as an individual contract counterpart.

  • Cash Flow Coverage Ratio means, for any period, the ratio of (i) Adjusted Parent Operating Cash Flow for such period to (ii) Corporate Charges for such period.