Prescription drug plans are complicated, and when you're selecting your Sun Life Drug coverage in your Total Rewards enrollment process, you might have some questions about each plan's coverage details. Let's define some of that terminology:
- Mandatory Generic Substitution: This means that when you fill a prescription for a brand name drug, the pharmacist will instead dispense the lowest-price equivalent (usually the generic) version of that drug, even if "No Substitution" is written on the prescription. If a brand name drug is dispensed, you will be responsible for the cost difference between the brand name cost and your coverage for the generic equivalent. While generic drugs are significantly less expensive, they still use the same active ingredients as brand name drugs.
- Dispensing Fee Cap Amount: A dispensing fee is a small fee that the pharmacy charges for filling your prescription, above and beyond the cost of the drug itself. The dispensing fee cap amount is the maximum that your drug plan will pay to cover the dispensing fee. This cap is set to $11.99.
- Maintenance Dispensing Fee Fill: This refers to the maximum number of prescription refills, per year, where your drug plan will cover the dispensing fee. This provision only applies when filling maintenance drugs.
After your enrollment period has concluded on November 15th, 2019, you'll be able to review your selected Sun Life Drug coverage (including your detailed policy booklet) in your League Wallet. Click here for a step-by-step walkthrough.