Brand/Generic Difference Clause Samples

Brand/Generic Difference. If you have a covered prescription filled with a brand name drug, as defined by MediSpan® and there is a generic equivalent drug for that brand name drug, and you have not obtained an exemption based on the medical necessity for the brand name drug, you must pay the Tier 1 Cost Share, plus the difference in cost between the generic and the brand name drug, not to exceed the cost of the drug, for each 30 day supply. The amount you pay for the difference between generic and brand will not apply to any maximum benefit, out of pocket maximum or deductible.