What if the charges are higher than “usual and customary”?
A. You do not have to be concerned about “usual and customary” charges with this HMO coverage. You pay only your applicable copayment for covered services. Back to top Q. How are prescriptions covered? A. If Hometown Health Plan provides your prescription benefit, you must have a participating pharmacy fill your prescriptions (refer to your Provider Directory). The pharmacy will fill prescriptions to the amount prescribed but never to exceed a 30-day supply. Since Hometown Health Plan uses a formulary (a list of approved medications), your prescribed medication must be on the formulary to be covered. For formulary generic drugs, you will pay a low copayment per prescription. You will have to pay a slightly higher copayment for a formulary brand-name drug that does not have a generic-drug equivalent. For a formulary brand-name drug that has an approved generic-equivalent drug on the formulary, you will pay the brand-name copayment amount plus the difference in cost between the generic d
