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Prescription drugs are playing an increasingly important
role in treating many diseases and may actually, in some
cases, be substituted for other kinds of medical treatment.
Most private insurance policies, especially those offered
through employers, cover prescription drugs. But rising
drug costs have prompted employers and their agents to impose
higher co-payments and deductibles for their drug benefits.
In addition, most insurers and employers have created incentives
to use generic drugs.
The three-tier payment program offers distinct co-payment
levels for brand-name and generic drugs. The lowest co-payment
level is for generic drugs, a higher co-payment for brand-name
drugs on the Preferred Drug List (Formulary) and the highest
co-payment for brand-name drugs not on the formulary list.
Pharmacy insurance plans frequently vary the coverage depending
on whether or not the patient uses an "approved"
pharmacy; that is, one that's part of the insurer's network
of contracted pharmacies.
Most pharmacy plans include an Internet order service allowing
the highest level of convenience, privacy and cost control.
This incorporates a convenient mail order program that provides
even greater savings for long-term maintenance medications
with the convenience of home delivery.
In summary, the increasing use of prescription drugs in
treating patients and the accompanying rise in the prices
of drugs are making it necessary for companies across the
insurance industry to evaluate and modify the structure
and cost of the prescription drug benefit on a regular basis.
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