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Prescription Drug Coverage Requirements

To be considered for coverage under the Plan, prescription drugs must first be:

  • Available on the formulary managed by the Plan's pharmacy benefit manager;

  • Prescribed by a licensed provider;

  • Dispensed by a licensed pharmacist;Found to be medically necessary for the treatment of the participant's illness or injury;

  • Food and Drug Administration (FDA) approved; and

  • Not otherwise excluded from coverage under the Plan.