10 GCA § 2912.7: Prescription Drug Coverage.

(a) The following drug prescriptions shall be covered:

(1) Out-patients prescribed drugs are provided in accordance with the Drug Formulary.

(2) Medically Indigent Program clients will have to pay a Two Dollars and Fifty Cents ($2.50) co-payment charge per prescription filled and shall be limited to generic brand items. Those with cost sharing liabilities shall pay the required co-payment charge plus their cost sharing liability.

(3) Pharmaceutical prescriptions, with the exception of birth control prescriptions, dispensed for ninety (90) days are limited to a thirty (30) day supply at one (1) time.

(b) Prescription Drug Services Not Covered. The following prescription drug benefits shall not be covered under the Medically Indigent Program:

(1) drugs not listed in the established formulary and requested with justification for consideration;

(2) over-the-counter drugs not listed in the established MIP formulary; and

(3) experimental drugs, unless approved by the Administrator.

(c) Limitations and Exclusions. All prescription drug benefits are subject to the stated benefit limitations and exclusions outlined in § 2912 through § 2913.