a prescription drug has a supply limit or maximum unit of measure quantity limit coverage per person/plan year is subject to TrueScripts’ periodic review and modification. Any one retail non-specialty prescription is limited to a ninety (90) day supply and any authorized refills, per Script. “DISPENSED AS WRITTEN” DRUG PROVISION The Rx Program requires that retail pharmacies dispense generic when available unless the prescriber specifically prescribes a brand name drug and marks the prescription “dispense as written.” “Dispense as Written” prescriptions may require a Prior Authorization. Should a Participant choose a Brand name drug, rather than the generic equivalent when the prescriber does not indicate Dispense as Written, the Participant may be responsible for the applicable Brand name drug copay plus the cost difference between the Brand and generic drugs. Additionally, only the applicable generic copay the Participant would have paid may apply toward the Participant’s deductible and / or out-of-pocket maximum. PRESCRIPTION DRUGS LOST AS A DIRECT RESULT OF A NATURAL DISASTER Participants will be given the opportunity to prove that prescription drugs otherwise considered covered expenses under this plan were lost due to a natural disaster. Acceptable proof could include, but not necessarily be limited to, proof of other filed claims of loss (homeowner’s, property, etc.). COVERED EXPENSES The following are prescription products considered covered expenses under the Rx Program: 1. Medications that are necessary for the care and treatment of an illness or injury and are prescribed by a duly licensed medical professional; 2. Medications which can be obtained only by prescription and dispensed in a container labeled “Rx Only”; 3. The following non-prescription (OTC) drugs prescribed by a duly licensed medical professional: a. Medications or vitamins as required by the Affordable Care Act; b. In an amount not to exceed the day’s supply outlined in the prescription schedule of benefits; and c. All other non-prescription OTC drugs that are included in the Medical Component Plan document. 4. Medications for medical treatment or prescription coverage not otherwise excluded by the Medical Component Plan or this Rx Program; and 5. Covered medications prescribed and filled while the Participant is a Participant in this Rx Program. Huntington County Community Schools Prescription Benefits Program SPD January 1, 2025 Page 8 of 15