Generic drugs are products that are
comparable to a brand-name drug in dosage form, strength, route of
administration, quality, performance characteristics, and intended use.
Generics are usually available at a significant cost-savings compared to the brand-name
drug. The generic drug substitution program requires that generic drugs be
dispensed when available. A beneficiary who chooses a brand name drug when
a generic is available, will have to pay the difference between the cost of the
brand name drug and the generic drug plus the standard copayment.
If a beneficiary has
already tried and cannot take the generic drug due to a specific medical
reason(s), their doctor should fax a letter of medical necessity to
1-888-487-9257 to provide medical information concerning why the generic
medication should not be dispensed. If the exception request is approved,
the beneficiary will only pay the standard copayment. Please see link below.
Generic Specialty Preferred Product Drug List here.
Medical Necessity Form here.