[mids1999]

Can someone please explain this in simpler terms and how does this associate to me as a type 1 diabetic?
I just got approved for Pennsylvania Medical Assistance.

Also please tell me what a legend drug is?

http://www.hrsa.gov/reimbursement/st...d-Services.htm

From above linked page

Prescription Drugs

The MA Program covers legend drugs except as where specified as well as certain nonlegend drugs if medical necessity has been established and the service has been prescribed or ordered by a licensed prescriber within the scope of the prescriber’s practice.


The licensed prescriber certifies that a specific brand is medically necessary by doing all of the following:

· Writes on the prescription form ‘‘Brand Necessary’’ or ‘‘Brand Medically Necessary’’ in the prescriber’s own handwriting.

· Receives prior authorization from the Department to use the brand name product and writes the prior authorization number on the prescription form.

Payment for prescriptions is limited to quantities consistent with the medical needs of the patient not to exceed a 34-day supply or 100 units, whichever is greater.

[lgvincent]

I think a legend drug is a drug with the following stated on its label "caution: federal law prohibits dispensing without a prescription."

[JasonSmithMT]

Yes, what lgvincent said. Another common way to think of it, albeit not the exact definition, is legend drugs are prescription drugs and non-legend drugs are over the counter drugs.

And for those who want to know the exact definition as it applies to the United States look at section 503(b) of the Federal Food, Drug and Cosmetic Act

Jason