Prescription Drugs

Prescription drug coverage is an important and valued part of an employee benefits package. Various drug plans and options are available to help contain benefit costs resulting from escalating prescription drug prices and dispensing fees. Encouraging the use of generic drugs is an important first step. Generic drugs contain the same active ingredients and are designed to work the same way as brand name drugs. The main difference is the price.

Three examples of drug benefit plans are:

Mandatory Generic Plan:
Mandatory Generic drug plans limit the coverage to the price of the least expensive generic drug available on the market. In some instances, if there is a medical reason that an employee cannot take the generic version, they can have their physician complete a form to request an exception to have the brand name reimbursed.

Central Dispensing Pharmacy:
Insurers partner with mail-order pharmacies to provide employees with an alternative way to receive their maintenance prescriptions. Employees continue to receive a high level of care by the pharmacist, while lower dispensing fees and drug cost mark-ups help to manage the cost of providing coverage.

Managed Rx Plan:
A Managed Rx plan encourages the use of lower cost generic and therapeutic alternatives by incorporating a two-tiered formulary for reimbursement, combined with the advantages of a Central Dispensing Pharmacy. Prescriptions purchased through the Central Dispensing Pharmacy are reimbursed at a higher percentage level than those purchased at a local pharmacy.