Prescription Drugs
Drug therapy is an important part of your employees’ health
care. HMSA promotes proper use of prescription drugs and works
to help keep your employees’ share of drug costs down.
Explanation of Formulary
HMSA’s drug plan is designed to give your employees a choice of
prescription drugs while sharing costs through copayments:
- First tier (generic drugs – lowest copayment): Generic drugs
are sold under their common generic or chemical name. Generics have the same active
ingredients as their brand-name equivalents and have been found to be safe and
effective by the U.S. Food and Drug Administration (FDA). We encourage the use of
generics because their low cost results in the lowest copayment.
- Second tier (preferred brand drugs – higher fixed copayment):
Some brand-name drugs are designated as preferred brand drugs when generic
alternatives are not available or do not adequately represent a therapeutic
class. Preferred brand drugs have a higher, fixed copayment than generics.
- Third tier (other brand drugs – higher fixed copayment plus differential):
Other brand drugs have a higher member copayment. For most members, the out-of-pocket cost
for other brand drugs is the second-tier copayment plus the differential. The differential
is the difference between the average cost for other brand drugs and the average cost for
generic and preferred brand drugs.
Choose Generic
The high cost of prescription drugs is a critical factor in rising health
care costs locally and nationally. HMSA encourages the use of generic drugs
to help our members manage their prescription drug costs. Generic drugs
contain the same active ingredients, and are safe and just as effective as
brand-name drugs. The biggest difference is that generic drugs cost less because
generic manufacturers don’t have the investment and marketing costs of the
developer of a new drug.