Members and eligible retirees clearly weren’t happy when the DC 37 Health and Security Plan raised drug co-payments July 1 in response to double-digit increases in the annual cost of prescription medications.

But despite the co-pay hikes, covered members continue to enjoy huge savings. “We needed the co-pay increases to preserve our drug benefit, because the soaring cost of medication was eating up too much of our reserves,” said Rosaria R. Esperon, administrator of the DC 37 Health and Security Plan.

“Despite higher out-of-pocket costs, covered individuals still get tremendous savings under the plan. It’s mind-boggling to consider what you would pay without the union benefit.” The DC 37 Health and Security Prescription Drug Plan is a mandatory generic medication program. That means if you use a brand-name drug when a generic equivalent is available, you are charged the difference in the cost plus the appropriate co-pay.

Generics, preferred list
To maximize your savings, use generic drugs whenever you can. Under the union plan, generics have the lowest co-pay — $5 for 30-day pharmacy purchases and $10 for a 90-day supply by mail order. For maintenance medication, you are required to use the mail order program.

Besides using generics, another way to save more is to make sure you use medication on the preferred list of brand-name drugs. The list includes hundreds of recommended medications, including many for which the plan’s administrator, Express Scripts, has negotiated discounts.

The DC 37 plan has a $15 co-pay for a month’s supply of preferred drugs purchased at a pharmacy and $30 for a 90-day supply by mail order. If you opt for a brand-name drug that has a generic equivalent and is not on the preferred list, you have to pay the difference between the cost of the two drugs plus the higher co-pay. The co-pay for non-preferred, brand name drugs is $35 for a 30-day supply from a pharmacy and $70 for a 90-day supply by mail.

Even though the co-pays are higher for non-preferred brand-name drugs, the plan still provides significant savings. The chart below shows the average retail price of common brand name drugs and indicates how, thanks to their DC 37 drug card, members save on their purchases of preferred and non-preferred medications.

Individuals who use non-preferred brand-name drugs should consult with their physician to consider switching to a preferred medication. But the medical appropriateness of the drug — not the cost — should always be the chief consideration, according to Express Scripts, Inc. When your doctor prescribes new drugs, ask for free samples to test how they work and save money.

If you have any questions about your medications and whether you can reduce your co-payments, feel free to call ESI at 1-800-467-2006.