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Employee Benefits - Prescription Drugs (annual maximum out-of-pocket feature)

  • Pays the cost of medication prescribed by a doctor or dentist and dispensed by a pharmacist. Employees may be required to pay a portion of the charge either 20% and/or a dispensing fee. Pay-direct drug cards are included as part of the benefit. Members are encouraged to elect mandatory generic prescription drug coverage over the brand named drugs to reduce costs.
  • One feature not found in other drug plans, is the annual maximum out-of-pocket feature. This plan feature limits the amount a single individual or family is required to contribute to their annual prescription drug costs. With the high cost of many of the drugs now available, this is a welcomed plan feature where a co-payment is required.

What is the difference between generic and brand name drugs?

  • A generic drug requires a prescription just like the brand name drug. They are chemically identical to a brand name drug and have the exact same performance characteristics, quality and intended outcome. They are subject to the same rigorous test protocols as the brand name drugs but are available at substantially lower costs.
  • Most provincial plans now mandate that pharmacies dispense the generic version of a brand name drug in order to reduce costs of prescription drugs provided to seniors.
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