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Employer Resources
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Frequently Asked QuestionsHow does the formulary save money? Can the plan member's physician prescribe drugs not on the formulary? Where can I find a copy of my company's formulary? Are generic drugs as good as brand name drugs? Do all brand name drugs have a generic equivalent? Why do some prescriptions require prior authorization? How does my plan's mail order benefit work? What is a formulary?A formulary is a list of prescription drugs approved under your insurance plan, including selected brand name drugs and most generic drugs. How does the formulary save money?Without decreasing quality of care, a formulary uses selected brand name drugs and moderately-priced generic drugs. When plan members buy a prescription drug from the formulary, they pay less than if they buy a drug that is not on the formulary. Can the plan member's physician prescribe drugs not on the formulary?Yes. But, if the physician prescribes a medication not on the formulary, the plan member will pay a higher co-pay for the drug. Where can I find a copy of my company's formulary?Your company's enrollment booklet contains a copy of your formulary. Or you can view your formulary here:
Are generic drugs as good as brand name drugs?Yes. The Food and Drug Administration (FDA) mandates that generic drugs are chemically equivalent and bioequivalent to their brand name counterparts. The FDA stringently enforces its rating policies on generic drugs to ensure safety and efficacy. Do all brand name drugs have a generic equivalent?No. But encourage your employees to ask if a generic equivalent is available whenever their physicians write prescriptions. Generics can save your employees and your plan money. Why do some prescriptions require prior authorization?Some drugs with certain risk factors must be approved before they can be prescribed. Physicians can obtain prior authorization by calling the number on the plan member's ID card. Review prior authorization instructions. How does my plan's mail order benefit work?If you have employees who are on maintenance drugs to treat a chronic condition on a regular or long-term basis, the mail order benefit can actually help them save money on copays and coinsurance. Encourage them to talk to their physician and have them ask if a maintenance prescription for a 90-day or 100-day supply would be appropriate. If so, have them use the prescription drug mail order form. If your employees have further questions, have them call the Express Scripts member service number on their ID card. |