Frequently Asked Questions (FAQs) (cont.)
Q. Does my plan cover medications that the FDA recently approved? A. We review all recently approved medications and products to see if they should be covered – and if so, at what cost-share (tier). It can take up to six months from the date the FDA approved them to make a decision. These include, but are not limited to, medications, medical supplies and/or devices covered under standard pharmacy benefits. If your doctor wants you to use a recently approved medication, he or she can ask Cigna Healthcare to consider approving it through the coverage review process. Q. Which medications are covered under the health care reform law? A. The Patient Protection and Affordable Care Act (PPACA), commonly referred to as “health care reform,” was signed into law on March 23, 2010. Under this law, certain preventive medications (including some over- the-counter products) may be available to you at no cost-share ($0), depending on your plan. Log in to the myCigna App or myCigna.com , or check your plan materials, to learn more about how your plan covers preventive medications. You can also view the PPACA No Cost-Share Preventive Medications drug list at Cigna.com/PDL . For more information about health care reform, go to www.informedonreform.com or CignaHealthcare.com . Q. What are preventive medications? A. Preventive medications are used to keep certain conditions from developing or from coming back. These conditions include, but are not limited to asthma, depression, diabetes, heart attack, high blood pressure, high cholesterol, osteoporosis, prenatal nutrient deficiency and stroke.
you get to the pharmacy counter – or, even before you leave your doctor’s office . 3
Q. What’s a cost-share? A. It’s the amount you pay out of your own pocket for a covered prescription and/or an eligible health care or related service. For some plans, the cost-share is a copay; for other plans, it’s a coinsurance. Q. How can I save money on my prescription medications? A. Consider using a medication that’s covered on a lower tier (such as a generic or preferred brand medication) or by filling a 90-day supply (if your plan allows). You should talk with your doctor to see if one of these options may work for you. Q. What's a generic medication? A. A generic medication is the same as its brand- name version in safety, effectiveness, quality, strength and dosage, as well as in the way it’s taken and used. 4 Brand-name medications are protected by patents. Patents keep other manufacturers from selling generic versions of the brand-name medication. Once a patent ends, other companies can make and sell a generic version of the brand-name medication. Generics are typically sold under their chemical or scientific name, instead of the manufacturer’s patented brand name. Q. Do generics work the same as brand-name medications? A. Yes. A generic medication works in the same way and provides the same clinical benefit as its brand- name version. Q. What are the differences between generic and brand-name medications? A. The medications may look different. For example, generics may have a different shape, size or color than their brand-name versions. They may also have a different flavor, have different preservatives, come in different packaging and/or with different labeling and may expire at different times. Generics may look different than their brand-name versions, but they’re just as safe and effective.
Q. How can I find out how much I’ll pay for a specific medication?
A. When you and your doctor are considering the right medication for your treatment, knowing how much it costs, what lower-cost alternatives are available and which pharmacies offer the best prices can help you avoid surprises. Log in to the myCigna App or myCigna.com and use the Price a Medication tool to see how much your medication costs before
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