What do quantity limits set by the plan or Medicare refer to?

Quantity limits set by the plan or Medicare specifically refer to the maximum amount of medication that a member can receive at a time. This is put in place to ensure that medications are used appropriately and to help prevent potential abuse or overuse. By establishing these limits, plans can manage costs effectively and support the safe usage of medications. These limits can also be based on clinical guidelines, which consider factors such as the typical dosage for a condition and the need for ongoing treatment. This approach helps to balance the need for adequate treatment with responsible prescribing practices.