Prescription Medications definition
Examples of Prescription Medications in a sentence
This means that a medication-specific quantity limit may apply to Prescription Medications that have an increased potential for over-utilization or an increased potential for a Member to experience an adverse effect at higher doses.
However, any Prescription Medications that require Prior Authorization will be treated as a Claim for benefits subject to the Claims and Appeals Procedures, as outlined in this Contract.
A copy of the list of covered Prescription Medications, drugs requiring Prior Authorization and drugs that are a part of the Progressive Medication Program are available from AvMed’s Member Engagement Center or from the AvMed website.
The list of Prescription Medications requiring Prior Authorization is subject to periodic review and modification by ▇▇▇▇▇ and may be amended without notice.
Except for emergencies, covered Prescription Medications must be obtained at Participating Pharmacies.
Pharmacy means a pharmacy (retail, mail order or specialty pharmacy) that has entered into an agreement to provide Prescription Medications to AvMed Members and has been designated as a Participating Pharmacy.
You also have the opportunity to obtain a 90-day supply of Prescription Medications used for chronic Conditions including asthma, cardiovascular disease, and diabetes, from a retail Participating Pharmacy or via mail order for the applicable cost-sharing per 30-day supply.
Please refer to your Schedule of Benefits for cost-sharing amounts for Prescription Medications ordered through mail services.
Retail Prescription Medications may be covered when accompanied by a prescription from your Attending Physician, subject to the cost-sharing shown in the Schedule of Benefits.
Please refer to your Prescription Medication Amendment for cost-sharing amounts for Prescription Medications ordered through mail services.