Drug Plan Information

Download prescription claim form and submit to:

MedImpact Healthcare Systems, Inc.
PO Box 509098
San Diego, CA  92150-9098

A cost-saving feature of your drug plan

• One of the features of WEA Trust drug policies is that a pharmacist will substitute generic medications for brand-name drugs whenever an FDA-approved generic equivalent is available. Generic substitution is part of our cost-effectiveness policy that limits reimbursement to the most cost-effective treatment from among viable alternatives*.
• Physicians may at times write a prescription as “Dispense As Written” (DAW), meaning a pharmacist cannot substitute an FDA-approved generic medication. Since a brand name drug is significantly more expensive, a DAW prescription will bring additional member costs unless it is preauthorized by the WEA Trust. For DAW prescriptions that are not preauthorized, the member must pay the applicable brand copayment plus the difference in cost between the brand drug and the generic*.

Member options to lower costs

• If a member is willing to use an FDA-approved generic equivalent, but their current prescription states, “DAW, Brand Medically Necessary,” or “No Substitution,” the member will need a new prescription without any of those notations to allow for the generic to be dispensed.
• The doctor writing the prescription may seek preauthorization by contacting MedImpact, the WEA Trust’s pharmacy benefit manager, at 888.807.8106. The doctor will need to present compelling clinical evidence indicating why the brand name drug is medically necessary. If our pharmacists and physicians agree this evidence supports the brand name drug over the generic equivalent, the member will only be responsible for the appropriate brand copayment. However, an indication from your Physician that a drug must be dispensed as written, without supporting objective, contemporaneous medical documentation, is not, by itself, sufficient evidence for us to reimburse for that drug. Other factors to consider would be other reasons that may have caused an apparent altered response to a drug, such as disease state fluctuation, lifestyle changes or life events, change in comorbid conditions, interacting medications recently prescribed, change in adherence to the generic medication, etc. Any exception request must be submitted to us by your Physician and authorized by us in advance of your receiving the prescription.
• Reimbursement Limit—This policy limits reimbursement to the most cost-effective treatment from among viable alternatives (see “Cost-Effectiveness Limit” in Section 4). If you purchase a brand name drug, we may limit reimbursement to the amount charged us by a participating pharmacy for the FDA-approved generic equivalent. In this case, you must pay the difference between the cost of the drug you received and the amount charged us by a participating pharmacy for the FDA-approved generic equivalent, in addition to your coinsurance or copayment. This usually results in significant out-of-pocket expense. 

Instead of standing in line at the pharmacy, you can have medications you take on a regular basis delivered to your home. And potential savings on copays.

Click here to access the WEA Trust Formulary.