Some of my meds are generic, some are not. Lyrica, for example isn't available yet in generic. I was taking Copaxone ($100 monthly co pay), and as far as I know, none of the DMDs are available in generic.

I believe in CA (I live here too) you should be able to receive non-generic drugs when none are available. I'm not sure if it is a law, or what. But that is my understanding. I think all I needed was the drs recommendation of the med. I have Anthem Blue Cross - HMO (a very good plan) and that's how they operate. Your insurance provider should be able to tell you what will be covered, but I know how hard it is to get a straight answer.

Good luck!

unless my MD gives me a good reason for using name brand version over an available generic {i.e. some seizure and thyroid meds}, I always opt for the cheaper generic. I tend to only use a name brand drugs when no generic is out on the market yet due to patent protections.

The generic Levothyroxine changed about 6 months ago. I know some people who've had to go on Synthroid after using generic for years.

I'm on Anthem PPO. It's not that I couldn't have the brand names, I'd just have to pay out of pocket. I looked at Lyrica before, and the pay out of pocket price was about the same as upgrading the insurance. It's more of the possible MS or other drugs to treat this horribleness that I worry about.

I'll call Anthem and talk to them about what would happen if I needed a brand name and didn't upgrade.

I also wonder if some of the drugs wouldn't be drugs, but would rather be treatments. Like if I got IVSM, it would be through the hospital, I'd assume I'd pay my percentage instead of the rx co-pay. Is this correct? I saw, for example, Tysabari I'd pay the percentage. But injectables, I'd have to pay the copay.

We don't have Targets with Pharms here. I hate WM and only go there if I have to.

I'm only on Prozac and LDN. Prozac is now generic and LDN is cheap.
I have had some bad luck with some generics in the past, though.
With all things NOT being equal.

Chaos, I think you are right that in-hospital IV's are charged by percentage rather than by co-pay. I have had two very expensive treatments for my Polycythemia Vera at Mayo. Medicare pays most of it, more than if I had to pay a drug co-pay. What I get is an IV "shot" which takes about ten minutes, but the drug itself is expensive. It is to reduce my number of platelets. My platelets and red cells seem to be holding steady right now....maybe I won't need to do this again. My cost is primarily air fare and motel for this, which I can take as a tax deduction...but it's still expensive to go for this treatment which is done at only a few places.

I use generics, Alprazolam and Zolipidem. I am fine there.

As far as the DMD's are concerned. I believe, each company has some type of program, to help off-set costs, if insurance isn't quite adequate. I'd personally, choose the lesser per month out of pocket insurance, if possible. More money in the wallet, each month, spaced over time, is more helpful.

Because there is that big IF, about a diagnosis.

Hope that helps.