- How does the prescription discount benefit work?
Outlook Rx will provide you with a member identification card. Once your physician has written you a prescription simply take it to be filled at one of our participating pharmacy locations. While at the pharmacy, present your Member ID to the pharmacist/pharmacy technician. Your prescription claim information will then be submitted electronically, in real time, to our prescription processor. Once our processor receives this claim information, your eligibility information will be verified and your discount price calculated. Our processor will then send a response to the participating pharmacy indicating what is owed by you the member.
- Will I save money on every prescription?
Outlook Rx members are guaranteed to pay the lower of our contracted rate or the pharmacy’s standard price. In most cases, our contract rate will save members an average of 10% to 50% depending on the drug type and which pharmacy location the member chooses to fill the prescription. Our participating pharmacy network is comprised of different types of pharmacies. Consequently, each pharmacy has different buying habits when it comes to purchasing their drug inventory and setting their standard price. Therefore, there may be instances, particularly for certain heavily marketed brand name drugs that a particular pharmacy’s standard price is better than our contracted rate.
- What is the difference between a brand drug and a generic drug?
There are two types of brand drugs; single source brand drugs and multi-source brand drugs. Single source brand drugs are those drugs that do not have a generic equivalent and are manufactured by the company who originated the drug. Single source brand drugs are protected by patent laws, allowing the original manufacturer to recoup the millions of dollars spent on the research and development process. Single source brand drugs are usually heavily marketed to physicians and consumers alike and are the most expensive drugs in the market place. Once this type of drug is introduced to the market it will be several years before the generic form of the drug is available. Common retail costs for a 30-day supply of a single source brand drug can range from $80 to $140 and higher. Multi-source brand drugs are less expensive than their single source counterpart. This is due to the fact that the patent protection is no longer in place and a generic form of the original drug is now being produced. Common retail costs for a multi-source drug can range from $30 to $50.
A generic drug is essentially a copy of the equivalent brand name drug. Although, the generic drug may look different than the brand name drug it must contain the same active ingredients. Before the FDA approves the generic drug, the manufacturer must prove that it contains the same active ingredients, meets the same standards of quality, strength, purity, identity, that it has the same rate and extent of absorption as the brand medication and is manufactured in compliance with current Good Manufacturing Practice regulations. Common retail costs for a 30-day supply of a generic drug can range from $10 to $30. However, it is important to note that newer single source generic drugs (former blockbuster brands; see example below) can see retail costs averaging from $50 to $80.
- When a brand drug finally goes generic, how much money can I expect to save?
When patent protection is finally exhausted for a brand drug, in most cases one manufacturer is awarded a six-month exclusive right to produce the generic form of that particular brand drug. Initially, the generic form of this drug is considered a single source generic since there is only one manufacturer. Therefore, in these instances consumers can expect to save an average of 10% to 15% off of the original brand price. For example, if the original brand cost for a 30-day supply were $120 the new generic costs would be $102 to $108. Only when the exclusivity period expires and multiple manufacturers begin to produce the generic form of the drug will consumers see a 40% to 50% discount off of the original brand price. Note: Generic drugs, to be true equivalents of the brand name medications, must be approved by the FDA.
- Can I use the Outlook Rx benefit if I already have prescription drug coverage?
If your current prescription drug coverage excludes certain prescribed medications, Outlook Rx may offer substantial savings on those medications.
- How can I maximize my savings utilizing the Outlook Rx discount prescription drug benefit?
Although Outlook Rx members will realize savings for both brand and generic drugs, the most significant savings are realized on generic drugs. Since, in most cases, there are multiple sources for generic drugs, the negotiated discounts amongst our participating providers for these drugs are greater and yield a bigger savings to the member. Therefore, in order to maximize your savings, if a generic drug is available, always request your physician prescribe you the generic drug. Or at the time of filling your prescription, if the pharmacy asks if you would like the generic equivalent, elect to take the generic drug.
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DISCLAIMER
This plan is a discount plan NOT a health insurance policy. This plan provides discounts at certain health care providers for medical services. This plan does not make payments directly to the providers of medical services. The plan member is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount medical plan organization. The DMPO does make available an up-to-date list of all program providers which includes their name, city & state, and medical specialty prior to purchase, upon request. That the range of discounts for medical services provided under the plan will vary depending on the type of provider and the medical services received. The corporate name and the location of the licensed discount medical plan organization is: Access One Consumer Health, Inc. 84 Villa Road, Greenville, SC 29615; 1-800-896-1962; www.accessonedmpo.com.
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