12849

Member for

7 years 1 month
Submitted by Site Factory admin on
Brand-Name Drugs Purchased When Generic Equivalent Available - When the member buys a covered drug, the pharmacist will provide a generic equivalent of the prescribed drug whenever it is allowed. If the member chooses to buy the brand-name drug instead of the generic drug equivalent, benefits will be calculated based on the member's benefits for the generic drug equivalent. This means that the member must pay the drug deductible, copayment, and/or coinsurance, whichever applies, plus all charges that are in excess of the allowed charge for the generic drug equivalent. For plans which include drug deductible, member pays the excess of the allowed charge amounts after the drug deductible amounts are met. All costs that are paid for these covered drugs, including excess charges, will count towards the member's out-of-pocket maximum.