Common use of Generic Drugs Clause in Contracts

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. 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 3 contracts

Sources: Group Subscriber Agreement, Group Subscriber Agreement, 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. 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 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

Sources: Group Subscriber Agreement

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. 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

Sources: 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. 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

Sources: Group Subscriber Agreement