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Coverage and cost

  • What happens when I give my pharmacist my prescription?

    • The pharmacist uses the number on your ID card to check the details of your plan. This way, the pharmacy can check to see if your plan covers the drug you were prescribed, based on your plan's formulary, or drug list.
    • They learn what your copay or cost share amount will be. This is the amount of money that you pay out-of-pocket for your prescription medicine.
    • If your prescription is for a brand-name drug, they find out if you could save money by using generic drugs instead of brand-name drugs. A generic drug has the same active ingredients as a brand-name drug, and is put on the market when the patent for the brand-name drug runs out. Using generic drugs can save you money.