If my mandatory generic appeal for a brand name drug has been approved, what will my copay be?
If your doctor feels it is medically necessary for you to have a brand name drug (that has a generic equivalent), you can appeal the Mandatory Generic Substitution requirement. If your appeal is granted, you can fill your prescription for the brand name drug at a retail or the mail order pharmacy. Since brand name drugs with a generic equivalent are not included on the preferred drug list, you will be responsible for the non-preferred drug copayment amount.
Related Questions
- How do I know whether to get prior authorization for a brand name drug through the PDP clinical call center or through the mandatory generic prior authorization system?
- What if I cannot take a generic medication that is on the preferred drug list? Can I still take a brand name drug for the generic copay?
- If my mandatory generic appeal for a brand name drug has been approved, what will my copay be?
