Participating Pharmacy Clause Examples for Any Agreement
Participating Pharmacy. When You go to a Participating Pharmacy, You must pay any Copayment and any applicable pricing differences. You may be required to pay for limited or non- Covered Services. No claim forms are required. If You are unsure whether a Pharmacy is a Participating Pharmacy, You may access the
Participating Pharmacy. When You go to a Participating Pharmacy, You must pay any Copayment and any applicable pricing differences. You may be required to pay for limited or non- Covered Services. No claim forms are required. If You are unsure whether a Pharmacy is a Participating Pharmacy, You may access the website at xxx.xxxxxx.xxx (Provider Finder) or contact customer service at the toll- free number on Your identification card.
Participating Pharmacy. When You go to a Participating Pharmacy: ▪ present Your Identification Card to the pharmacist along with Your Prescription Order, ▪ provide the pharmacist with the birth date and relationship of the patient, ▪ sign the insurance claim log, ▪ pay the Pharmacy Deductible, if applicable, and ▪ pay the appropriate Copayment Amount for each Prescription Order filled or refilled and the pricing difference, if any. Participating Pharmacies have agreed not to bill You for any covered prescription drug expenses in excess of the Pharmacy Deductible, if not previously satisfied, and Copayment Amount plus any pricing difference. If You are unsure whether a pharmacy is a Participating Pharmacy, You may contact the Customer Service telephone number shown on the back of Your Identification Card. You must present Your Identification Card to Your Participating Pharmacy in order to receive full Contract benefits.
Participating Pharmacy. We will only pay for prescription drugs for use outside of a Hospital. The prescription must be issued by a Participating Provider and filled at a Participating Pharmacy, except in an emergency or where otherwise authorized by Us.
Participating Pharmacy. Present your written prescription from your physician and your Identification Card to the pharmacist at a Participating Pharmacy. The Participating Pharmacy will file your claim for you. You will be charged at the point of purchase for applicable Deductible and/or Copayment or Coinsurance amounts. If you do not present your Identification Card, you will have to pay the full retail price of the prescription. If you do pay the full charge and you believe the Prescription Drug should be covered, ask your pharmacist for an itemized receipt and submit it to us for reimbursement consideration.
Participating Pharmacy. We will only pay for prescription drugs prescribed for use outside of a Hospital. Except in an emergency, the prescription must be issued by a Participating Provider and flled at a Participating Pharmacy. Under this Section, we will not pay for the following: • Administration or injection of any drugs. • Replacement of lost or stolen prescriptions. • Prescribed drugs used for cosmetic purposes only. • Experimental or investigational drugs. Member Services: 1-800-223-7242, TTY: 711 Crisis Line: 1-800-223-7242, TTY: 711 21 – AMA Drug Evaluations; – American Hospital Formulary Service; – U.S. Pharmacopoeia Drug Information; or • A review article or editorial comment in a major peer-reviewed professional journal. • Devices and supplies of any kind, except family planning or contraceptive devices, basal thermometers, male and female condoms, and diaphragms. • Prescribed drugs and biologicals and the administration of these drugs and biologicals that are furnished for the purpose of causing or assisting in causing the death, suicide, euthanasia or mercy killing of a person. • Prescription drugs used for purposes of treating erectile dysfunction. We will pay for up to forty visits per calendar year for home health care provided by a certifed home health agency that is a Participating Provider. We will pay for home health care only if you would have to be admitted to a Hospital if home care was not provided. Home care includes one or more of the following services: • Part-time or intermittent home nursing care by or under the supervision of a registered • professional nurse; • Part-time or intermittent home health aide services which consist primarily of caring for the patient; • Physical, occupational or speech therapy if provided by the home health agency; and • Medical supplies, drugs and medications prescribed by a physician and laboratory services by or on behalf of a certifed home health agency to the extent such items would have been covered if the covered person had been in a Hospital. We will pay for preadmission testing when performed at the Hospital where surgery is scheduled to take place, if: • Reservations for a Hospital bed and for an operating room at the Hospital have been made, prior to performance of tests; • Your physician has ordered the tests; • Surgery actually takes place within seven days of such preadmission tests. • If surgery is canceled because of preadmission test fndings, we will still cover the cost of these tests. We will pay for s...
Participating Pharmacy. Any registered, licensed retail pharmacy with whom the pharmacy benefit administrator or We have a contract to dispense Prescription Drugs to Members.
Participating Pharmacy. Any Pharmacy, including a mail order pharmacy, which has entered into a Prepaid Prescription Agreement with Blue Cross and Blue Shield of New Jersey, Inc. or any other Participating Blue Cross Plan indicated by Blues Cross and Blue Shield of New Jersey, Inc.
Participating Pharmacy. A Participating Pharmacy is a Pharmacy which has a Participating Pharmacy Agreement in effect with the Pharmacy Benefits Manager at the time services are rendered. Call your local Pharmacy to determine whether it is a Participating Pharmacy or call the toll-free customer service telephone number.
Participating Pharmacy. An in-network Retail Pharmacy, Mail Order Pharmacy, Specialty Pharmacy, or other pharmacy type that has entered into a pricing agreement with Bidder to dispense Covered Products to members.