Trustmark Prescription Drug Plan Glossary
Copay – The amount the insured member must pay each time he or she receives a covered prescription.
Coinsurance – A payment made by the insured in addition to the payment made be the insurance company on covered prescription charges or expenses.
DAW (Dispense As Written) – When a physician writes a prescription, he or she may designate on the form that the prescription must be dispensed as written. This means substitutions (usually generic drugs) may not be used. This is called a physician DAW. Under certain circumstances, the pharmacy or the cardholder may also request that the prescription be dispensed as written, but that type of DAW may involve an additional payment.
Deductible – Amount an insured is required to pay before his or her RX copay is applicable.
Formulary – A list of drugs that have been selected for therapeutic efficiency and best cost values; considered the agents of choice for a physician to prescribe.
MAC – Managed Allowable Cost.
Maintenance Drug – Any prescription drug that requires more than a 30-day supply. Most are used on a steady, year-round basis for long-term illness.
Generic Drug – The common usage of the term is to identify non-brand name drugs that are sold at a lower cost. Technically, a generic drug is a pharmaceutical equivalent to another drug and is identical in strength, concentration and dosage form.
Preferred Brand Drug – Preferred drugs are prescription drugs that have been approved as cost effective as well as therapeutically safe and effective.
Non-Preferred Brand Drug – Non-preferred drugs are prescription drugs that have been approved as therapeutically safe and effective, but the cost of these drugs is usually higher.
Tier 1 – Generic Drug, carrying the lowest copayment.
Tier 2 – Preferred Brand Drug, sometimes carrying a mid-level copayment.
Tier 3 – Non-Preferred Brand Drug, carrying the highest copayment
Source: America's Health Insurance Plans; http://www.ahip.org/
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