Formulary vs Generic benefits conflicting and confusing? New to non-state insurance.
I’m losing my state insurance and getting my jobs insurance at the end of the year so I’m trying to figure out how much my current Healthcare will cost after several years of medicaid paying for everything. Worried about finding out I can’t afford to maintain my healthcare.
Full med benefits for the highest priced monthly plan say:
Preventative Generic – $0
Generic – $0
Formulary or Brand – $35
Nonformulary or Nonbrand – $70
Specialty – $350
(All before deductible as the lowest priced plan requires the deductible to be met for all of these)
These seem to be conflicting since generics are on the formulary and everything I see says anything not on the formulary isn’t covered despite the previous two levels saying they’re zero cost and the next state they are double.
I dont understand if my generic meds will cost $0 or if they’ll end up being $35 if they’re on a formulary list? And is that like the max I’d pay for a drug more than that or is it $35 minimum plus cost? What if the drug is less than $35? None of this makes sense.
