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Although prescription drugs can be covered as any other illness, the most popular method is to have a three-tiered co-pay option. One option includes paying for generic drugs with a $5 co-pay, brand drugs with a $25 co-pay and non-formulary drugs with a $40 co-pay.
A second, less expensive option, covers generic drugs with a $20 co-pay, brand drugs with a $40 co-pay and non-formulary with a $60 co-pay. Under the second option, if a generic is available, it is required to be used.
We also have available a mail order drug program for use with the co-pay drug plan. This program allows your employees to order their "maintenance" drugs through the mail and receive a 90-day supply. This helps the employee by limiting the number of co-pays they have to pay and also reduces the cost to the plan by directing the order to the mail order pharmacy, which can purchase the drug in large quantities.
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