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MANAGED CARE May 2000. ©2000 MediMedia USA
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MANAGED CARE OUTLOOK
Similarity seen in prescription cost-sharing
The cost-sharing techniques that employers use in prescription drug benefit designs vary, but across types of health plans, there is remarkable similarity. For instance: Separate copayment levels for brand-name and generic drugs is the most common technique that employers use, but it's not necessarily seen more often in an HMO than in, say, a PPO. Even when comparing mail order benefit structures with those that apply when people buy prescriptions at the pharmacy counter, there is general uniformity across plans. The only form of cost sharing where some variance is evident is coinsurance, which is used more often in less-managed plans.
Some columns do not add to 100 percent because of rounding.
SOURCE: 1999 MERCER/FOSTER HIGGINS NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS.