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Frequently Asked Questions
How does the formulary save me money?
Can my physician prescribe drugs for me that are not on the formulary?
Where can I find a copy of my formulary?
Are generic drugs as good as brand name drugs?
Do all brand name drugs have a generic equivalent?
Why do some prescriptions require prior authorization?
How do I get started using my plan's mail order benefit?
What is a formulary?
A formulary is a list of prescription drugs approved under your insurance plan, including selected brand name drugs and most generic drugs.
How does the formulary save me money?
Without decreasing quality of care, a formulary uses selected brand name drugs and moderately-priced generic drugs. When you buy a prescription drug from the formulary, you pay less than if you buy a drug that is not on the formulary.
Can my physician prescribe drugs for me that are not on the formulary?
Yes. But, if your physician prescribes a medication not on your formulary, you will pay a higher co-pay for the drug.
Where can I find a copy of my formulary?
Your enrollment booklet contains a copy of your formulary. Or you can view your formulary online:
- 2005 Formulary (PDF)
- 2006 Formulary (PDF)
Are generic drugs as good as brand name drugs?
Yes. The Food and Drug Administration (FDA) mandates that generic drugs are chemically equivalent and bioequivalent to their brand name counterparts. The FDA stringently enforces its rating policies on generic drugs to ensure safety and efficacy.
Do all brand name drugs have a generic equivalent?
No. But whenever your physician prescribes a brand name drug, be sure to ask if a generic equivalent is available. Generics can save you money.
Why do some prescriptions require prior authorization?
Some drugs with certain risk factors must be approved before they can be prescribed. Your physician can obtain prior authorization for you by calling the number on the back of your ID card. Review prior authorization instructions.
How do I get started using my plan's mail order benefit?
If you are on maintenance drugs to treat a chronic condition on a regular or long-term basis, the mail order benefit can actually help you save money on copays and coinsurance. To get started, talk to your physician. Ask if a maintenance prescription for a 90-day or 100-day supply would be appropriate for you. If so, have your physician write your prescription and use the prescription drug mail order form. For further questions, please call the Express Scripts member service number on your ID card.