Frequently Asked Questions
Rx for Better Health
Who is eligible for Rx for Better Health?
Which generic drugs are eligible for the waiver?
Why is IBC waiving members’ cost sharing for certain generic drugs?
What is the difference between a brand name and a generic equivalent drug?
What if my drug is not available in generic form?
Will generic drug copayments or coinsurance be waived if I purchase drugs through mail order instead of at the local retail pharmacy?
What should I ask my doctor?
What if I am already taking drugs on the Rx for Better Health list for a chronic condition?
Why are some generic drugs on the Rx for Better Health list and others are not?
Why does Rx for Better Health waive costs for drugs that are typically prescribed for just seven chronic conditions? What about all the other chronic conditions?
How do I know if my drug is a generic drug?
How can I take advantage of this program?
If I have a generic prescription filled before July 1, 2008, for one the 75 drugs listed, am I still eligible for the waiver?
If I drop off a prescription prior to the start of the promotion, but wait until July 1, 2008, to purchase the prescription, is the prescription still eligible for the waiver?
If a member has a deductible with his or her prescription drug coverage, will the deductible amount be waived?
Who is eligible for Rx for Better Health?
IBC members who have the following commercial pharmacy benefits programs are eligible for Rx for Better Health: freestanding prescription drug programs, prescription drug riders, or medical programs with integrated prescription drug benefits.
Members who are not eligible are those with Medicare Part D drug plans, Medicare Discount Cards, Personal Choice HSA-Qualified programs, and the Federal Employees Health Benefit Plan (FEHB).
Which generic drugs are eligible for the waiver?
Rx for Better Health waives deductibles (for integrated drug only), copayments, and coinsurance on 75 generic drugs used to treat certain chronic conditions such as high blood pressure, high cholesterol, diabetes, depression, acid reflux, heart failure, and heart disease.
Why is IBC waiving members’ cost sharing for certain generic drugs?
Good health is the focus of our business at IBC. We are offering Rx for Better Health to encourage members to talk to their doctors and pharmacists about the appropriate use of generic drugs instead of more expensive brand name drugs for treating their chronic conditions. Rx for Better Health offers members an incentive to adhere to prescribed drug therapy for certain chronic conditions. Increasing the use of generics when appropriate will help contain health care costs for both our members and groups. Generic drugs provide the same quality, strength, and effectiveness as brand name prescription drugs, but they usually cost less.
What is the difference between a brand name and a generic equivalent drug?
According to the Food and Drug Administration, generic drugs are the same as their brand name equivalents in active ingredients, dosage, safety, strength and performance, and are held to the same strict standards as their brand name counterparts. The only noticeable difference between a generic and its brand name drug counterparts may be the shape and or color of the drug. While generic drugs are just as effective as the corresponding brand name drugs, they typically cost up to 70 percent less, which helps control health care costs. This helps you in the long run because the generic option is always the lowest cost to you.
What if my drug is not available in generic form?
Even if your drug is not available in generic form there may be a generic drug that could work just as well for you. If you are taking a brand name drug, you may want to talk to your doctor about which drugs could treat your condition. While a brand name drug is still protected under patent, a generic equivalent cannot be made. During this patent protection time, in the interests of saving money and maintaining optimal health, many patients and doctors will discuss the option of substituting a generic therapeutic alternative. A therapeutic alternative is actually the generic equivalent for a different brand name drug and treats the condition using a different active ingredient. For most of these patients, these substitutions work just as effectively.
Will generic drug copayments or coinsurance be waived if I purchase drugs through mail order instead of at the local retail pharmacy?
Yes. We will automatically waive any copayment or coinsurance amount on any generic drug on the attached list, whether filled through the mail order or participating retail pharmacy. Please note: If your prescription drug plan has a deductible, you are required to meet the deductible before becoming eligible for the waiver (except Integrated Drug coverage, where the deductible will be waived).
What should I ask my doctor?
Would one of these 75 generic drugs be a good option for me, and could it treat my condition in the same way? What other brand name drugs am I taking that could be replaced with generics?
What if I am already taking drugs on the Rx for Better Health list for a chronic condition?
If you are already taking one or more of the Rx for Better Health drugs, we encourage you to continue, as directed by your doctor. Please consider this program a reward for choosing generics and a way that you will be able to save money over the long term, since generics are always the lowest cost to you on your prescription plan.
Why are some generic drugs on the Rx for Better Health list and others are not?
The drugs selected for inclusion in Rx for Better Health were chosen by consideration of two factors. First, these generic drugs represent some of the highest used prescription drugs among all drugs, both within the IBC member population and on a national level. Secondly, the drugs selected have a tremendous amount of scientific evidence supporting their effectiveness. Clinical studies have proven there is a significant opportunity for improved health with these particular drugs. Many of them, in fact, are considered the treatments of choice by physicians.
Why does Rx for Better Health waive costs for drugs that are typically prescribed for just seven chronic conditions? What about all the other chronic conditions?
Rx for Better Health was designed as a program to focus on DRUGS that treat chronic conditions. We considered all drugs used to treat all chronic conditions and, using a very clear evidence-driven approach, we chose the generic drugs that had a significant opportunity to help our members overall. The generic drugs chosen represent some of the highest used prescription drugs among all drugs, both within the member population and on a national level.
How do I know if my drug is a generic drug?
Your doctor or pharmacist can tell you if the drug you are taking is brand or generic. You can also look up drugs by name through ibxpress.com.
How can I take advantage of this program?
Eligible members can take advantage of the savings in Rx for Better Health under several scenarios.
Eligible members getting new prescriptions written for them at upcoming physician visits are encouraged to ask their doctors about generic drug options. If the doctor agrees that one of these generic drugs is appropriate for the member, the member can ask the doctor to write a prescription for the generic drug.
Eligible members with existing brand name prescriptions that could be substituted with a generic equivalent are encouraged to ask the pharmacist whether a generic is available. If one is available, the member can ask that a generic drug be provided instead of the brand at the next refill. The pharmacist may contact the physician.
Eligible members with existing brand name prescriptions that could be substituted with a generic therapeutic alternative are encouraged to discuss the use of the generic drug with their doctor and if appropriate, obtain a new prescription for the generic therapeutic alternative.
Eligible members with existing generic prescriptions that are on the list may continue to use the generic drug. Copayments, and coinsurance* will be waived when future refills are filled or processed during the promotion period.
* and deductibles — for Integrated Drug members ONLY
If I have a generic prescription filled before July 1, 2008, for one the 75 drugs listed, am I still eligible for the waiver?
No. The program applies to these 75 generic prescriptions processed and filled between July 1, 2008, and December 31, 2008.
If I drop off a prescription prior to the start of the promotion, but wait until July 1, 2008, to purchase the prescription, is the prescription still eligible for the waiver?
It depends on the date the pharmacy actually processed the prescription. The Rx for Better Health waiver of copayment, and coinsurance* applies only to prescriptions that are processed and filled by the pharmacy between July 1, 2008 and December 31, 2008. The date on which the pharmacy processes and fills the prescription is the date that the pharmacy enters the prescription into the FutureScripts system, which is what determines eligibility. If you drop off a prescription on June 30, 2008, and the pharmacy processes it the same day and holds it for you to pick up, it is not eligible for the waiver, even if it is picked up on July 1, 2008. However, if the pharmacy processes and fills the prescription between July 1, 2008, and December 31, 2008, the prescription is eligible.
* and deductibles — for Integrated Drug members ONLY
If a member has a deductible with his or her prescription drug coverage, will the deductible amount be waived?
For eligible members with freestanding prescription drug programs or prescription drug riders, only coinsurance and copayment amounts at a participating pharmacy or through mail order will be waived. If the prescription plan has a deductible, the member must meet the deductible before becoming eligible for the waiver. Please note: this does not apply to members who have medical programs with integrated prescription drug programs.
For eligible members with medical programs that include integrated prescription drug benefits, they will continue to pay the full discounted price for covered generic prescriptions and receive a reimbursement check for any deductible, coinsurance, or copayment expenses incurred during the promotion. Reimbursement checks will be issued in October of 2008 for prescriptions processed between July 1, 2008 and September 30, 2008, and in February of 2009 for prescriptions processed between October 1st and December 31, 2008. All claims must be received by January 15, 2009.
