Back in October 2015, we had a Broker training session that touched on various topics, including the SBG members’ responsibility when it comes to Generic vs Brand drugs. A few questions have come up on this topic and we think this may provide clarification.
Generic vs Brand
Small group members may be responsible for cost difference between the brand and generic drug plus generic copay if a brand is dispensed when a generic is available. In this scenario, only the generic copay would apply towards the OOPM.
For more information, please contact your Health Net Representative
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