The maximum amount payable to an eligible brand name drug will be limited to the lowest priced item in the appropriate generic category.

The maximum amount allowed for a dispensing fee is $10.00. Any amount charged over and above will be payable by the student.

• Drugs which require the written prescription of a physician or dentist
• Injectable drugs including allergy serums and insulin
• Extemporaneous preparations or compounds if one of the ingredients is a covered drug
• Certain other drugs that do not require a prescription by law may be covered when prescribed by your physician or dentist. If you have any questions, contact your plan administrator before incurring the expense
• Contraceptive patch
• Nuva Ring (contraceptive)
• Oral contraceptives
• All acne preparations excluding Accutane or other acne preparations containing the same medicinal ingredient as Accutane
• IUD's
• Birth Control are covered at 100%.

Vaccinations are covered at 80% based on reasonable and customary charges. Administration costs associated with providing the injection are not covered.

The following diabetic supplies are covered to a maximum of $200 per benefit year

• Insulin syringes
• disposable needles for use with non-disposable insulin injection devices
• lancets and test strips

Drug Exception Process

If the medications covered by your insurance do not work for your condition, or if an effective drug is not covered, there is a special process to handle exceptions.

Download the form and print it, ask your doctor to complete the physician information section and submit your request to be considered for a drug exception.

To be considered for a drug exception, you must have tried at least one medication on your student health plan.

Prior-Authorization Drug Claims

Some prescription drugs require prior authorization before reimbursement is considered. You must submit a form to get prior authorization. Once prior authorization has been confirmed by the prescription search tool, you must work with your doctor to complete and submit a Drug Prior Authorization Form.