Generic Drugs. The Health Insurance Exchange Metal Level Formulary covers both brand-name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient and may be substituted for the brand-name drug. Generally, generic drugs cost less than brand-name drugs. Brand Name drugs when a generic Equivalent is Available A generic equivalent will be dispensed if available. If your prescriber requests to dispense a brand-name drug when a generic equivalent is available, the request will require a Medical Exception. If Medical necessity is established the non-preferred drug copay plus the difference between the brand-name and the generic drug will apply. Otherwise, brand-name drugs dispensed when a generic equivalent is available are not covered and will not count towards the deductible or annual out-of-pocket maximums.
Appears in 2 contracts
Samples: Subscriber Agreement, Subscriber Agreement
Generic Drugs. The Health Insurance Exchange Metal Level Formulary covers both brand-name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient and may be substituted for the brand-name drug. Generally, generic drugs cost less than brand-name drugs. Brand drugs. Brand-Name drugs when Drugs When a generic Generic Equivalent is Available Available A generic equivalent will be dispensed if available. If your prescriber requests to dispense a brand-name drug when a generic equivalent is available, available the request will require a Medical Exception. If Medical necessity is established the non-preferred drug copay plus the difference between the brand-name and the generic drug will apply. Otherwise, brand-name drugs dispensed when a generic is equivalent is available are not covered and will not count towards the deductible Deductible or annual out-Annual Out- of-pocket maximumsMaximum.
Appears in 1 contract
Samples: Presbyterian Health
Generic Drugs. The Health Insurance Exchange Metal Level Formulary covers both brand-brand name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient and may be substituted for the brand-name drug. Generally, generic drugs cost less than brand-name drugs. Brand Brand-Name drugs when Drugs When a generic Generic Equivalent is Available Available A generic equivalent will be dispensed if available. If your prescriber requests to dispense a brand-name drug when a generic equivalent is available, the request will require a Medical Exception. If Medical necessity Necessity is established the non-preferred drug copay plus the difference between the brand-name and the generic drug will apply. Otherwise, brand-name drugs dispensed when a generic equivalent is available are not covered and will not count towards the deductible or annual out-of-pocket maximums.
Appears in 1 contract
Samples: Group Subscriber Agreement
Generic Drugs. The Health Insurance Exchange Metal Level Formulary covers both brand-name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient and may be substituted for the brand-name drug. Generally, generic drugs cost less than brand-name drugs. Brand Brand-Name drugs when Drugs When a generic Generic Equivalent is Available Available A generic equivalent will be dispensed if available. If your prescriber requests to dispense a brand-name drug when a generic equivalent is available, available the request will require a Medical Exception. If Medical necessity is established established, the non-preferred drug copay plus the difference between the brand-name and the generic drug will apply. Otherwise, brand-name drugs dispensed when a generic is equivalent is available are not covered and will not count towards the deductible or annual out-out- of-pocket maximums.
Appears in 1 contract
Samples: Subscriber Agreement
Generic Drugs. The Health Insurance Exchange Metal Level Formulary covers both brand-name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient and may be substituted for the brand-name drug. Generally, generic drugs cost less than brand-name drugs. Brand Name drugs when a generic Equivalent is Available Available A generic equivalent will be dispensed if available. If your prescriber requests to dispense a brand-name drug when a generic equivalent is available, the request will require a Medical Exception. If Medical necessity is established the non-preferred drug copay plus the difference between the brand-name and the generic drug will apply. Otherwise, brand-name drugs dispensed when a generic equivalent is available are not covered and will not count towards the deductible or annual out-of-pocket maximums.
Appears in 1 contract
Samples: Subscriber Agreement