Standard Option Generic Incentive Program
Your cost-share will be waived for the first 4 generic prescriptions filled (and/or refills ordered) per drug per calendar year if you purchase a brand-name drug listed below while a member of the Service Benefit Plan and then change to a corresponding generic drug replacement while still a member of the Plan.
Preferred Retail Pharmacy
- Your 20% coinsurance amount (15% when Medicare Part B is primary) is waived for the first 4 generic drug replacements filled (and/or refills ordered) per drug per calendar year. You may receive up to 4 coinsurance waivers per drug change per year.
- If you switch from one generic drug to another, you will be responsible for your coinsurance amount.
- Both the brand-name drug and its corresponding generic drug replacement must be purchased during the same calendar year.
Mail Service Prescription Drug Program
- Your $15 copayment ($10 when Medicare Part B is primary) is waived for the first 4 generic drug replacements filled (and/or refills ordered) per drug per calendar year. You may receive up to 4 copayment waivers per drug change per year.
- If you switch from one generic drug to another, you will be responsible for the copayment.
- Both the brand-name drug and its corresponding generic drug replacement must be purchased during the same calendar year.
| If you take one of these
brand-name drugs... | And change to one of these generic
drug replacements... | |
|---|---|---|
| Actonel, Boniva, Fosamax | alendronate | You will receive your first 4 prescription fills (or refills) of the corresponding generic drug at no charge.
(Please see the Standard Option Generic Incentive Program description above for complete information.) |
| Aciphex, Dexilant (formerly Kapidex), Nexium, Prevacid, Prilosec, Protonix, Zegerid | omeprazole, lansoprazole, or pantoprazole | |
| Ambien CR, Lunesta, Rozerem | zaleplon, zolpidem, or zolpidem extended-release | |
| Beconase AQ, Nasacort AQ, Nasonex, Omnaris, Rhinocort Aqua, Veramyst | fluticasone or triamcinolone acetonide nasal spray | |
| Advicor, Altoprev, Crestor, Lescol, Lescol XL, Lipitor, Livalo, Mevacor, Pravachol, Simcor, Vytorin, Zocor | simvastatin, pravastatin, or lovastatin | |
| Caduet | simvastatin, pravastatin, lovastatin, or amlodipine | |
| Toprol XL | metoprolol SR | |
| Famvir | famciclovir | |
| Valtrex | valacyclovir | |
| Atacand, Avapro, Benicar, Cozaar, Diovan, Micardis, Teveten | losartan | |
| Atacand HCT, Avalide, Benicar HCT, Diovan HCT, Hyzaar, Micardis HCT, Teveten HCT | losartan HCTZ | |
| Detrol, Oxytrol, Sanctura, Toviaz, Vesicare | Oxybutynin, oxybutynin extended-release, or trospium | |
| Detrol LA, Enablex, Sanctura XR | oxybutynin extended-release |
Please note the list of eligible generic drug replacements may change if additional generic drugs corresponding to the listed brand-name drugs become available during the year. For the most up-to-date information, please visit our Pharmacy Program .
Page last updated: January 05, 2012