There are three categories of covered drugs with three different copayments: generic drugs, preferred brand-name drugs, and nonpreferred brand-name drugs.
You will pay the lowest copayment for generic drugs. Generics are equivalent to their brand-name counterparts, and are ensured by the Food and Drug Administration to be as safe and effective. However, generics cost 30 to 70 percent less than brand-name drugs.
Preferred Brand-Name Drugs
These are drugs for which generic equivalents are not available. They have been in the market for a time and are widely accepted. Express Scripts has arranged a significant discount on these drugs. They cost more than generics, but less than nonpreferred brand-name drugs.
You may obtain a list a preferred brand-name drugs at www.express-scripts.com or by calling 800-818-6632.
Non-preferred Brand-Name Drugs
These drugs have the highest copayment, and there is a special coinsurance amount of 50 percent for fertility medications. Generally these are higher-cost medications that have recently come on the market. In most cases, an alternative preferred medication is available. If a physician prescribes a brand-name drug when a generic equivalent is available, you must pay the difference in cost in addition to a copayment.
If you require a nonpreferred brand-name drug, you can ask Express Scripts to review your case.
Contact your campus Benefits Office for more information on addressing these types of cases.