WAC Premium charged must be no greater as a result of a family or individual receiving PKU benefits. Prescription 42 USC Required §18021 Plan must cover "prescription drug services" in a manner substantially Drug Services Prescription (a)(1)(B); equal to the base-benchmark plan. For purposes of determining a plan's (EHB) Drug 42 USC Services actuarial value, an issuer must classify as prescription drug services 18022(b)(1)(F) medically necessary prescribed drugs, medication and drug therapies. WAC 284-43-5642(6) WAC Plan must include the following services, which are specifically covered by the base-benchmark plan, and classify them as prescription drug services: Drugs and medications both generic and brand name, including self- prescription medications, WAC Prescribed medical supplies, including diabetic supplies that are not otherwise covered as durable medical equipment under the rehabilitative and habilitative services category, including test strips, glucagon emergency kits, insulin and insulin syringes; Prescription Required WAC All FDA-approved contraceptive methods, and prescription-based Drug Services Prescription sterilization procedures for women with reproductive capacity (EHB) Drug Services WAC "Prescription contraceptives" include United States Food and Drug (Cont’d) (Cont’d) Administration (FDA) approved contraceptive drugs, devices, and prescription barrier methods, including contraceptive products declared safe and effective for use as emergency contraception by the FDA.); WAC Plan must not cover prescription contraceptives on a less favorable basis than other covered prescription drugs and prescription devices. Coverage of prescription contraceptives includes coverage for medical services associated with the prescribing, dispensing, delivery, distribution, administration and removal of a prescription
WAC Premium charged must be no greater as a result of a family or individual receiving PKU benefits. Prescription Drug Services (EHB) Prescription Drug Services (EHB) (Cont’d) Required Prescription Drug Services Required Prescription Drug Services (Cont’d) 42 USC §18021 (a)(1)(B); 42 USC 18022(b)(1)(F) Plan must cover "prescription drug services" in a manner substantially equal to the base-benchmark plan. For purposes of determining a plan's actuarial value, an issuer must classify as prescription drug services medically necessary prescribed drugs, medication and drug therapies. WAC 284-43-5642(6) WAC Plan must include the following services, which are specifically covered by the base-benchmark plan, and classify them as prescription drug services: Drugs and medications both generic and brand name, including prescription medications, WAC Prescribed medical supplies, including diabetic supplies that are not otherwise covered as durable medical equipment under the rehabilitative and habilitative services category, including test strips, glucagon emergency kits, insulin and insulin syringes; WAC All FDA-approved contraceptive methods, and prescription-based sterilization procedures for women with reproductive capacity WAC "Prescription contraceptives" include United States Food and Drug Administration (FDA) approved contraceptive drugs, devices, and prescription barrier methods, including contraceptive products declared safe and effective for use as emergency contraception by the FDA.); WAC Plan must not cover prescription contraceptives on a less favorable basis than other covered prescription drugs and prescription devices. Coverage of prescription contraceptives includes coverage for medical services associated with the prescribing, dispensing, delivery, distribution, administration and removal of a prescription self-
checklist-forms-2018-hmo-individual-analyst-checklist.docx