Generic drugs are drugs that are no longer protected by trademark. They are sold under the common chemical formulation name.

Brand name drugs are protected by trademark and are more expensive. They include drugs commonly advertised on television. Most health care plans encourage the use of generics instead of brand name drugs. In some plans, generics may be mandatory. In this case, if you try a generic drug and it does not work for you (and your doctor has documented this), your doctor may appeal to the plan to substitute a brand name drug.

Formulary drugs are on a list of preferred approved drugs covered under the health care plan. Typically, pharmacists are used to assist health plans in evaluating which drugs should be included on the formulary. They take into account the therapeutic value, safety, side-effects, drug-to-drug interaction and cost effectiveness of the drug versus other medications in the same drug category. Plans will usually offer cost incentives to use formulary drugs.

Non-formulary drugs are not listed on the plan's formulary are considered brand non-formulary drugs and are either 1) not covered, or 2) if covered, are usually much more expensive.

When your doctor writes you a prescription, you should ask if the drug is a generic or brand drug and if it is on the plan's formulary. Drugs can be researched on the plan's web site (if available) or you can call the customer service line to inquire about a drug.

You can fill a prescription in one of two ways: either at a retail pharmacy or through mail order.

If you need the prescription filled immediately, you should purchase it at an in-network retail pharmacy. You can usually find a list of in-network pharmacies on your health care plan's Web site. You can also call the number on your ID card, or you can ask your local pharmacy if they belong to the network. If this is your first pharmacy visit, you should present your medical plan ID card so the pharmacist can make a copy of it for his files. The pharmacist will fill your prescription and charge you the appropriate co-pay. Some plans don't cover prescriptions purchased at out-of-network pharmacies.

Plans are moving away from flat dollar co-pays towards charging participants a percentage of the cost up to a dollar limit. In the latter case, we recommend that you contact several retail pharmacies in your network; different pharmacies may charge different amounts for the same drug.

The other alternative to filling a prescription is to use the mail order pharmacy. This is the most cost effective method for maintenance drugs because you usually receive a three-month supply for the cost of a two-month co-pay. A maintenance drug is one that you take regularly on an on-going basis, such as for high blood pressure or cholesterol. For your first mail-order prescription, you will need to complete an order form, attach the original prescription from your doctor along with the appropriate co-pay or credit card information, and then mail it to the mail order pharmacy. A refill order form will usually be included in the package when you receive your medications. Many plans also allow you to request refills by mail, telephone or by Web site.

If you will be taking the prescription on an on-going basis, you should ask your doctor for two signed prescriptions. You can use one to get a prescription filled immediately from the retail pharmacy and then send the second one in to the mail order pharmacy for an extended supply and refills. The mail order pharmacy will send your medications directly to your home within 2-3 weeks.