CIGNA High Deductible Health Plan (HDHP) - UCAR Finance ...

Pharmacy
The term Pharmacy means a retail Pharmacy, or a home
delivery Pharmacy.
Drugs and Related Supplies included in the Prescription Drug
List have been approved in accordance with parameters
established by the P&T Committee. The Prescription Drug
List is regularly reviewed and updated.
HC-DFS61 04-10
Pharmacy & Therapeutics (P & T) Committee
A committee of CIGNA Participating Providers, Medical
Directors and Pharmacy Directors which regularly reviews
Prescription Drugs and Related Supplies for safety and
efficacy. The P&T Committee evaluates Prescription Drugs
and Related Supplies for potential addition to or deletion from
the Prescription Drug List and may also set dosage and/or
dispensing limits on Prescription Drugs and Related Supplies.
HC-DFS62 04-10
Physician
The term Physician means a licensed medical practitioner who
is practicing within the scope of his license and who is
licensed to prescribe and administer drugs or to perform
surgery. It will also include any other licensed medical
practitioner whose services are required to be covered by law
in the locality where the policy is issued if he is:
• operating within the scope of his license; and
• performing a service for which benefits are provided under
this plan when performed by a Physician.
HC-DFS25 04-10
Prescription Drug
Prescription Drug means; a drug which has been approved by
the Food and Drug Administration for safety and efficacy;
certain drugs approved under the Drug Efficacy Study
Implementation review; or drugs marketed prior to 1938 and
not subject to review, and which can, under federal or state
law, be dispensed only pursuant to a Prescription Order.
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HC-DFS64 04-10
Prescription Order
Prescription Order means the lawful authorization for a
Prescription Drug or Related Supply by a Physician who is
duly licensed to make such authorization within the course of
such Physician's professional practice or each authorized refill
thereof.
HC-DFS65 04-10
Primary Care Physician
The term Primary Care Physician means a Physician who
qualifies as a Participating Provider in general practice,
internal medicine, family practice or pediatrics; and who has
been selected by you, as authorized by CIGNA, to provide or
arrange for medical care for you or any of your insured
Dependents.
HC-DFS40 04-10
Psychologist
The term Psychologist means a person who is licensed or
certified as a clinical psychologist. Where no licensure or
certification exists, the term Psychologist means a person who
is considered qualified as a clinical psychologist by a
recognized psychological association. It will also include any
other licensed counseling practitioner whose services are
required to be covered by law in the locality where the policy
is issued if he is operating within the scope of his license and
performing a service for which benefits are provided under
this plan when performed by a Psychologist.
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HC-DFS63 04-10
Prescription Drug List
Prescription Drug List means a listing of approved
Prescription Drugs and Related Supplies. The Prescription
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HC-DFS26 04-10
Related Supplies
Related Supplies means diabetic supplies (insulin needles and
syringes, lancets and glucose test strips), needles and syringes
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