Enhanced Generic Substitution

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 Opens a new website 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.