Question: What recourse do I have if my insurer will cover only a generic version of a prescribed drug?

To help ensure that you receive the brand-name version of the drugs prescribed to you, ask your physician to mark your prescriptions "DAW" (dispense as written). Your physician should do this anyway if a drug's generic equivalent is not appropriate for your condition. Otherwise, your pharmacist may be required to fill your prescription with a generic equivalent. But your insurer may not allow you to get brand-name drugs in every instance, depending on the terms of your health plan.

To deal with the rising cost of prescription medications, health insurers encourage providers to substitute many brand-name drugs with their generic equivalents. Although you may sometimes get the brand names by paying a higher co-payment, some health-care plans offer coverage only for generic drugs. If this is the case with your insurer, you may have to pay out of your own pocket if you want a brand-name drug. But speak with your primary care physician. If you have a condition that medically warrants the use of a brand-name medication that is not covered under your prescription plan, your doctor can petition your insurer for special coverage as a matter of medical necessity.

Remember that both brand-name and generic medications are approved by the U.S. Food and Drug Administration. In nearly all instances, the generic equivalent of a particular medication is an appropriate and less expensive substitute for the brand-name version.


Prepared by Broadridge Advisor Solutions Copyright 2022.

You may also like

Choosing Investments for Your Retirement Savings Plan
Choosing Investments for Your Retirement Savings Plan
24 September, 2020

Your employer-sponsored retirement plan offers a variety of investments to choose from. How do you know which ones may b...

Buying a Fuel-Efficient Vehicle
Buying a Fuel-Efficient Vehicle
17 March, 2017

You’re searching for a new car and interested in fuel-efficient vehicles. On the surface, they sound like a good idea: Y...