Yes. The Food and Drug Administration (FDA) will not approve a generic drug unless it’s A-rated ("therapeutically equivalent"). It must be identical to the brand-name version — same active ingredients, dosage and strength and medical effect.
Depending on their plan design, members can help control the amount they pay for their prescriptions by requesting that their prescriber prescribe generic medications. Generic medications don't compromise the quality of your care.
Your prescriber and pharmacist are the best sources of information about generic medications. Simply ask one of them if your prescription can be filled with an equivalent generic medication.
If your current prescription medication is not a generic, call your prescriber and ask if it's appropriate for you to switch to a lower-cost generic drug. The decision is up to you and your prescriber.
You may request that your prescriber prescribe the brand-name drug even when a generic version is available. However, you may have to pay the difference in cost between the generic and brand-name drug, plus the co-payment.
Brand-name drugs are usually available from only one manufacturer and may have patent protection. When a drug company develops a new drug, they're the only ones allowed to make and sell it under their “brand name.” At some point, other companies are allowed to start making "generic" versions. Generic drugs are required by law to have the same active ingredients as their brand-name counterparts, but are normally only available after the patent expires on a brand-name drug. People using generic over brand-name medications can typically save money.
Some plans require you to use a generic version when there is one, or you may need to pay a higher copay or coinsurance. Check your plan details to see how your plan works.
Some plans require you to use a generic version when there is one, or you may need to pay a higher copay or coinsurance. Check your plan details to see how your plan works.
A drug list/formulary is a list of prescription drugs that we cover. This list is made up of hundreds of brand-name and generic drugs approved by the U.S. Food and Drug Administration (FDA). We update the drug list/formulary several times a year. Our drug list/formulary decisions are based first on quality data, instead of cost.
Prescriptions for certain drugs (or the prescribed quantity of a drug) may require “prior authorization” from a health benefits plan before they can be filled. Some drugs require prior authorization because they may not be appropriate for every member or may cause side effects. Prior authorization helps promote appropriate utilization and enforcement guidelines for prescription drug coverage.
“Step therapy” involves prescribing medication only after a “first line” drug is tried. In instances in which one of these medications is not effective and/or appropriate for a particular member, the step therapy requirements allow the prescriber to then prescribe a different medication.
“Step therapy” involves prescribing medication only after a “first line” drug is tried. In instances in which one of these medications is not effective and/or appropriate for a particular member, the step therapy requirements allow the prescriber to then prescribe a different medication.
When your prescriber gives you a prescription for a drug, take it to a pharmacy in your network. Show your member ID card so the pharmacist can access your benefits. If you have medications that you take regularly, you may be able to have them conveniently and securely shipped to a location of your choice.
Most plans have different coverage levels for drugs based on whether they're generic or brand-name — or other factors. Those on higher "tiers" may require you to pay more in coinsurance.
Our medication list (sometimes called a formulary) allows you and your doctor to choose from a wide variety of prescription drugs. Please talk with your doctor about prescribing a drug that is on the medication list. If a drug is selected that is not on the medication list, you will be responsible for the full cost of the drug. You can also talk to your doctor about making a request to CarelonRx for an exception review of a drug not on the medication list.
From your secure online account, select Prescriptions from the main navigation and then select Prescriptions Home. There you'll find links for the specialty pharmacy.
Normally, a generic drug can be introduced to the market only after the patent has expired on its brand-name counterpart and can be offered by more than one manufacturer. Using generic medications may save you money.
