How your prescription drug coverage works

The university wants to help you use your prescription drug benefits wisely and will be introducing new programs in 2018 to help you get the best medication at the right price. More information about these programs will be available in next month's HR NewsWire.

It's important to understand drug categories (or tiers) and the associated costs. There are three tiers of medications that specify how a drug will be covered:

Generic drugs

Generic drugs are identical to their brand-name equivalents in dosage, safety, strength, quality, and all other performance measures. They are typically sold at 30 to 75 percent less than brand-name drugs, and this means lower costs for you and for the university.

Formulary brand-name drugs

Sometimes brand-name drugs are needed to help treat problems when there is not a generic option. Formulary brand-name drugs are drugs on Express Scripts' formulary list that are preferred under Johns Hopkins' health plans because they offer the greatest overall value. If a generic version is not available, your provider will likely prescribe a formulary brand-name drug.

Nonformulary brand drugs

Nonformulary brand drugs are drugs not on the preferred drug list because there is a less-expensive generic or formulary brand alternative. They are usually more expensive for you than generic and formulary brand-name equivalent medications that work just as well. If your doctor believes that there are special reasons you should continue using your current brand of medicine, he or she can request a coverage review. Or, you can call Express Scripts Member Services to request a review of your coverage.

For more information about prescription drug coverage, visit myChoices in October.