Examples of Drug Benefits in a sentence
If your Employer selected the optional Prescription Drug Benefits Rider, and Blue Shield denies an exception request for coverage of a non-Formulary Drug, you may submit a grievance requesting an external exception request review.
Family planning services may also be covered under the Preventive Health Services Benefit and the Prescription Drug Benefits Rider, if your Employer selected it as an optional Benefit.
Asthma inhalers and inhaler spacers are covered under the Prescription Drug Benefits Rider, if your Employer selected it as an optional Benefit.
All claim types are eligible to be processed through Inter-Plan Arrangements, as described above, except for all Dental Care Benefits, and those Prescription Drug Benefits or Vision Care Benefits that may be administered by a third party contracted by us to provide the specific service or services.
Prescription Drug Benefits* Your Cost Plan-year out-of-pocket maximum $1,000 per member $2,000 per family At designated retail pharmacies (up to a 30-day formulary supply for each prescription or refill) No deductible $10 for Tier 1** $30 for Tier 2 $65 for Tier 3 Through the designated mail service pharmacy (up to a 90-day formulary supply for each prescription or refill) No deductible $25 for Tier 1** $75 for Tier 2 $165 for Tier 3 * Cost share waived for certain orally-administered anticancer drugs.
For grievances due to denial of coverage for a Non-Formulary Drug: If your Employer selected the optional Outpatient Prescription Drug Benefits Supplement as a Benefit and Blue Shield denies an exception request for coverage of a Non-Formulary Drug, the Member, representative, or the Provider may submit a grievance requesting an external ex- ception request review.
Inter-Plan Arrangements Eligibility – Claim Types All claim types are eligible to be processed through Inter-Plan Arrangements, as described above, except for all Dental Care Benefits except when paid as medical claims/benefits, and those Prescription Drug Benefits or Vision Care Benefits that may be administered by a third party contracted by BCN to provide the specific service or services.
Note: If medications are prescribed, and your Employer selected the optional Outpatient Pre- scription Drug Benefits Supplement as a Bene- fit, the applicable Copayment or Coinsurance will apply.
Prescription Drug Benefits - All of the health care plans offer prescription benefits.
The contribution will provide active employees with the following benefits pursuant to and in accord with the Benefit Plan maintained by the Teams Local Union No. 856 Health and Welfare Trust Fund: Health & Welfare Plan D Prescription Drug Benefits Vision Care Benefits Domestic Partner Coverage Retiree Health & Welfare The employer shall not be liable for any increase in health and welfare contributions in excess of the amount set forth in this Section.