Prescription drugs are covered under a 3-tier plan.
- Generic drugs- you pay 25%
- Preferred name brand drugs- you pay 30%
- Non-preferred name brand drugs- you pay 50%
Preferred name brand drugs are drugs that are on Wellmark's preferred list.
If you purchase a brand name drug when an FDA-approved “A”-rated generic equivalent is available, you are responsible for your co-payment or coinsurance, plus any difference between the billed charge for the brand name drug and the billed charge for the generic. This can result in you paying substantially higher costs than if you had chosen the generic drug.
If your physician feels it is important for you to have the brand name drug, they can write the prescription for the brand name drug with the direction, “Dispense as Written” on the prescription. In this situation you will not be responsible for the difference between the billed charge for the brand name drug and the billed charge for the generic drug.