Common use of Dispensing Limits Clause in Contracts

Dispensing Limits. Drug dispensing limits are designed to help encourage medication use as intended by the FDA. Coverage limits are placed on medications in certain drug categories. Limits may include: quantity of covered medication per prescription, quantity of covered medication in a given time period, coverage only for members within a certain age range. The Plan evaluates and updates dispensing limits quarterly or annually. If you require a prescription in excess of the dispensing limit established by the Plan, ask your Health Care Practitioner to submit a request for clinical review on your behalf. The request will be approved or denied after evaluation of the submitted clinical information. If medically necessary criteria is not met, you will be responsible for the full cost of the prescription beyond what your coverage allows. Payment for benefits covered under this section may be denied if drugs are dispensed or delivered in a manner intended to change, or having the effect of changing or circumventing, the stated maximum quantity limitation. To determine if a specific drug is subject to this limitation, you can refer to the Plan's website at ▇▇▇.▇▇▇▇▇▇.▇▇▇ or call the customer service toll‐free number on your identification card.

Dispensing Limits. Drug dispensing limits are designed to help encourage medication use as intended by the FDA. Coverage limits are placed on medications in certain drug categories. Limits may include: quantity of covered medication per prescription, quantity of covered medication in a given time period, coverage only for members within a certain age rangerange and coverage only for members of a specific gender. The Plan evaluates and updates dispensing limits quarterly or annuallyquarterly. If you require a prescription in excess of the dispensing limit established by the Plan, ask your Health Care Practitioner to submit a request for clinical review on your behalf. The request will be approved or denied after evaluation of the submitted clinical information. If medically necessary criteria is not met, you will be responsible for the full cost of the prescription beyond what your coverage allows. Payment for benefits covered under this section may be denied if drugs are dispensed or delivered in a manner intended to change, or having the effect of changing or circumventing, the stated maximum quantity limitation. To determine if a specific drug is subject to this limitation, you can refer to the Plan's website at ▇▇▇.▇▇▇▇▇▇.▇▇▇ or call the customer service toll‐free toll-free number on your identification card.

Dispensing Limits. Drug dispensing limits are designed to help encourage medication use as intended by the FDA. Coverage limits are placed on medications in certain drug categories. Limits may include: quantity of covered medication per prescription, quantity of covered medication in a given time period, coverage only for members within a certain age rangerange and coverage only for members of a specific gender. The Plan evaluates and updates dispensing limits quarterly or annuallyquarterly. If you require a prescription in excess of the dispensing limit established by the Plan, ask your Health Care Practitioner to submit a request for clinical review on your behalf. The request will be approved or denied after evaluation of the submitted sub­ mitted clinical information. If medically necessary criteria is not met, you will be responsible for the full cost of the prescription beyond what your coverage allowsal­ lows. Payment for benefits covered under this section may be denied if drugs are dispensed dis­ pensed or delivered in a manner intended to change, or having the effect of changing or circumventing, the stated maximum quantity limitation. To determine if a specific drug is subject to this limitation, you can refer to the Plan's website at ▇▇▇.▇▇▇▇▇▇.▇▇▇ or call the customer service toll‐free toll-free number on your identification card.