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Prescription

1-30 Day

31-60 Day

61-90 Day

90 Day Supply

Drug Type

Supply

Supply

Supply

(or less)

Generic Drug

$12

$24

$36

$24

Preferred

$30

$60

$90

$60

Co-Payments Prescription drug co-payments for retail pharmacies and the mail order service are as follows:

Retail Pharmacies

Mail Order

In most instances, when a generic drug is available and the participant purchases the brand name drug, the participant will pay the difference in the cost of the brand name drug and the generic drug, plus the generic co-payment amount. Based on the price of some generic drugs, co-payment other than the generic co-payment may apply.

$100

$150

$100

Brand Drug Other/Non- Preferred Drug (no generic equivalent)

$50

NOTE: Participants in Base Coverage will be charged the full allowable charge for each 30 day supply until the annual deductible is met.

Generic Drugs Typically, generic drugs cost less than equivalent brand-name drugs. Because the generic drug co- payment is less, participants save money when purchasing generic drugs. Participants are encouraged to use generic drugs whenever allowed by their physician. To be covered by the Plan, a generic drug must:

  • Contain the same active ingredients as the brand-name drug (inactive ingredients may vary);

  • Be identical in strength, form of dosage, and the way it is taken;

  • Demonstrate bio-equivalence with the brand-name drug; and

  • Have the same indications, dosage recommendations, and other label instructions (unless protected by patent or otherwise exclusive to the brand-name).

Preferred Brand Drugs A list of preferred brand drugs is maintained by Catalyst Rx. Preferred drugs are chosen based on their clinical appropriateness and cost effectiveness. Catalyst Rx has the right to add drugs to the list at any time. Deletions will only occur on an annual basis. A copy of the list can be obtained by contacting Catalyst Rx directly or through the Plan’s web site at http://knowyourbenefits.dfa.state.ms.us.

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