Are only outpatient prescription drugs covered?
This Prescription Drug List only applies to outpatient prescription drugs dispensed by participating pharmacies. This list does not apply to inpatient medications or to medications obtained from and/or administered by a physician. Will a preferred brand drug be dispensed instead of a non-preferred brand drug? Physicians are encouraged to utilize the generic or preferred brand drugs on this list when prescribing medications for Members. If a pharmacist receives a prescription for a non-preferred brand drug, depending on the Member’s plan design, the pharmacist may attempt to contact the physician to request a change to a preferred product. If the physician is unwilling to change, or is unavailable, the pharmacist will dispense the prescription as written and the applicable copayment (cost share) will apply.
