Limitations and Eligible Medications: All medications are eligible unless noted below. The following drugs/products are EXCLUDED from coverage for the Rx Gold Plan Prescription Benefit. Products purchased from a non-participating pharmacy. Drugs or medications purchased with a prescription in excess of a 30 days supply, lawfully obtainable with a physician's prescriptions whether or not in same unit dosage (i.e. over-the-counter - OTC Medications), or dispensed more than one year after the date of the prescription; experimental drugs or drugs labeled "Caution - limited by Federal Law to investigational use"; medications consumed or administered where dispensed; refills in excess of the number authorized; charges for the administration of any drug; oxygen (including administrations); therapeutic devices or support garments.
The plan offered is a prescription savings plan and not insurance. Plan is subject to change. The plan may be suspended, cancelled or otherwise terminated with notice.
Contact Us
