Non-Preferred Drug definition

Non-Preferred Drug means a drug on the MTUS Drug List which is designated as requiring authorization through prospective review prior to dispensing the drug. The Non-Preferred Drug status of a drug is designated in the column labeled “Preferred / Non-Preferred”.

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Non-Preferred Drug means a non-covered drug, that may include both brand-name and generic drugs considered as non-formulary (also called a “Non-Preferred Drug”) and is not included on a Preferred Drug List (PDL). Non-Quantitative Treatment Limits (NQTLs) NQTLs are limitations on benefits or services that are not expressed numerically, but otherwise limit the scope or duration of benefits. Not Otherwise Medicaid Eligible refers to individuals not eligible for Medicaid services under New Mexico’s Medicaid State Plan.

Non-Preferred Drug means a drug on the New York Pharmacy

Examples of Non-Preferred Drug in a sentence

• If a Member requests a Non-Preferred Drug, for which the provider has not indicated “dispense as written” (DAW), the Member will be responsible for the full cost of that drug.

• Effective January 1, 2015, the prescription drug coverage provided by PEF under the PEF Healthcare Plan will use a three tier formulary established by the third party administrator selected by PEF to administer the plan with the following co-pays: Prescription Drugs – Retail Pharmacy Copays: 30 Day Supply Tier 1 – Generic Drug 0* Tier 2 – Preferred Drug $20 Tier 3 – Non-Preferred Drug $35 *At the third Retail Pharmacy fill and each refill thereafter, the Generic copay is $10.

• If a Member requests a Non-Preferred Drug, for which the prescribing provider has not indicated “dispense as written” (DAW), the Member will be responsible for the full cost of that drug.

• The appropriate Preferred Generic, Preferred Brand or Non-Preferred Drug Cost Sharing Copayment required for each type of Prescription Drug or refill is as follows: o One Cost Sharing Copayment per 30-day supply up to the maximum dosing recommended by the manufacturer/FDA.

• The MCO and the MCO’s providers must charge copays for the following MCO services and members:  Inpatient and outpatient services;  Non-Preferred Drug List medications;  Non-emergency use of an emergency department;  Caretaker relatives age 21 and up;  Transitional Medicaid members age 21 and up; and  Any other members identified by the MCOs that are not specifically exempt.

More Definitions of Non-Preferred Drug

Non-Preferred Drug means those drugs that are 3rd tier or higher on an individual's Medicare Part D Prescription Drug Plan's (PDPs) formulary or are listed as non-preferred on the Department's Preferred Drug List.

Non-Preferred Drug means a prescription drug that is [in a therapeutic class that is] included in the preferred drug program and is not one of the drugs on the preferred drug list [in that class] because it is either: (a) in a therapeutic class that is included in the preferred drug program and is not one of the drugs on the preferred drug list in that class or (b) manufactured by a pharmaceutical manufacturer with whom the commissioner is negotiating or has negotiated a manufacturer agreement and is not a preferred drug under a manufacturer agreement.

Non-Preferred Drug means a specialty drug formulary classification for certain specialty drugs that are subject to limits on eligibility for coverage or to higher cost-sharing amounts than preferred specialty drugs.

Non-Preferred Drug means a tier designed for certain drugs deemed non-preferred and therefore subject to

Non-Preferred Drug means a Specialty drug formulary classification for certain Specialty drugs deemed non-preferred and therefore subject to limits on eligibility for coverage or to higher cost-sharing amounts than preferred Specialty drugs.

Non-Preferred Drug means a prescription drug that is in a therapeutic class that is included in the preferred drug program and is not one of the drugs on the preferred drug list in that class.

Non-Preferred Drug means a drug in a tier designed for