Prescription Drug

From SmartMedicalConsumer Wiki

A drug that can only be purchased with a physician’s prescription. Insurance providers often categorize drugs into tiers. The tiers are Generic, Preferred-brand and Non-preferred brand. The amount of co-payment or coinsurance may vary based on the tier the prescription drug falls into.

• Generic: Generic drugs are those whose active ingredients, safety, dosage, quality and strength are identical to that of its brand counterpart. These medications are covered at the generic co-payment or coinsurance and typically cost less than preferred-brand drugs.
• Preferred-brand: Preferred-brand drugs are those which generally have no generic equivalent. These medications are covered at the preferred brand co-payment or coinsurance under the plan.
• Non-preferred brand: Non-preferred brand drugs are those which generally have equally effective and less costly generic equivalents and/or have more preferred-brand options. A participant or his/her provider may decide that a medication in this category is best. These medications are usually covered at the highest co-payment or coinsurance level.