Generic substitution
Reimbursing at the generic price where one exists.
Under mandatory generic substitution the plan reimburses at the lowest-cost equivalent price, with the employee paying the difference for a brand-name product unless an exception applies.
Most plans include an exception process where a physician documents that the brand is medically necessary.
What this means for a BC plan
This aligns a private plan with how BC PharmaCare already reimburses, which reduces confusion for employees who interact with both.
Related terms
Where this comes up
What drives the price of a plan · All glossary terms · Ask an advisor directly
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