Authorized Generics - (A008)

Coverage of Authorized Generics versus their Reference Brand drugs is plan-dependent: Cigna designates specific products as Covered or Not Covered by formulary (e.g., Anoro Ellipta, Flector, Mitigare, Otovel, RoxyBond, Tresiba, Triglide are listed as covered on many plans while their Authorized Generics are often not covered; Individual & Family Plans have specific insulin designations). All coverage is subject to the customer's benefit plan/formulary, applicable medical-necessity and documentation requirements, non-covered alternatives are allowed only if the covered formulary product is unavailable, and oxycodone (authorized generic) is allowed only if the patient meets opioid-policy criteria and RoxyBond is not available.

"Cigna covers either or both of the Reference Brand Drug or associated Authorized Generic Drug noted in the tables below based on the customer's benefit plan, including the formulary."