Prescription drug coverage

Enhanced Generic Substitution

Limiting coverage to the cost of generic drugs is a key way to help keep your drug plan affordable without compromising your plan member’s health. They can be significantly cheaper than their brand name equivalent.

Our Enhanced Generic Substitution File opens in a new window (EGS) plan option limits coverage to the cost of the lowest-priced generic alternative.

This encourages plan members to use the generic medication over the brand-name drug, which can save plan members money if they pay a portion of the cost of the prescription.

For example, consider a brand-name drug that costs $100 and a generic equivalent that costs $20. Assuming the plan provides 100% coverage, the plan member would be required to pay $80 if the brand-name drug was dispensed, but zero if the generic equivalent was selected.