A prescription drug that has the same active-ingredient(s) as a brand drug. Generic drugs usually cost less than brand drugs.

A formal complaint you make about us or one of our network pharmacies, including a complaint concerning the quality of your care. A grievance is NOT a complaint about coverage or payment disputes.

The maximum limit of coverage under the Initial Coverage Stage.

Amount you pay until you and the plan pay a total of the initial coverage limit set by CMS for your current plan year. Please visit the Member Benefit page for more information.

When you are first eligible for Medicare, the period of time when you can sign up for Medicare Part A and Part B. For example, if you’re eligible for Medicare when you turn 65, your Initial Enrollment Period is the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.

Doctors, hospitals, pharmacies and other health care providers that have agreed to provide members of a certain insurance plan with services and supplies at a pre-determined price. In some HMO plans, your care is only covered if you get it from in-network doctors, hospitals, pharmacies, and other health care providers.

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