A benefit feature that encourages use of generic drugs will be included in all 51-100 health benefits plans.
All Aetna 51-100 new business and renewing plans with December 1, 2012 and later effective dates will include a benefit feature that encourages members to use generic drugs as a first choice. Ultimately, the member has the choice to use a brand or a generic.
Below are the two scenarios for members purchasing brand name drugs:
1.)If there is a brand name drug with a generic equivalent but the brand name drug is dispensed and the physician did not specify on the script “Dispense as Written” the member will pay the difference in cost between the brand and generic drug plus the applicable copay or cost sharing required by the plan for the brand name drug dispensed.
2.)If a there is a brand name drug with a generic equivalent but the brand name drug is dispensed and the physician did specify on the script “Dispense as Written” the member will pay the applicable copay or cost sharing required by his or her plan for the brand name drug dispensed.
Aetna’s Price-a-DrugSM tool lets members check what they’ll pay for their prescriptions. Members are able to:
• Compare the costs of generic versus brand-name drugs
• Estimate the cost of a drug at retail versus ordering through mail-order delivery
• See how much they can save
To use the tool, members can visit www.aetna.com and log in to Aetna Navigator®. Then, they can click on “Aetna Pharmacy” and “Get Drug Prices.”
If you have any questions or would like additional information please contact Your Benefit Guardian or reach out to Aetna Member Services.
