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Pharmacy:
3-Tiered Pharmacy Program: Generic vs. Brand Formulary vs. Brand Non-Formulary
| Tier # 1 |
Tier #2 |
Tier #3 |
| Generic - Covered drugs that are no longer protected by a drug company patent allowing other drug companies to manufacture equivalent versions of the same drug at a reduced cost. Generic medications may be purchased with the lowest co-payment. |
Formulary - A list of brand name medications that PHP doctors are encouraged to prescribe for covered members. Formulary Medications may be obtained at a slightly higher co-payment than the generic medications. |
Non-Formulary - Covered drugs that are not included in the Formulary drug listing. PHP members have the option to obtain Non-Formulary brand name medications but at the highest level of pharmacy co-payment. |
Example:
If a doctor prescribes a: Generic Drug
Brand Formulary Drug*
Brand Non-Formulary Drug* |
Co-payment is: $5
$15
$40 |
Please note that co-payment amounts will vary depending on the benefit plan purchased.
*If you or your doctor want a brand name drug when there is a generic drug available, you may pay more than your Formulary or Non-Formulary Brand co-payments.
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