Frequently Asked Questions
Why Am I Being Given A Generic?
- The FDA ( Food and Drug Administration) makes sure generics are identical to the brand-name in 3 ways:
- They must have the same active ingredient
- The dose and strength must be identical
- The overall quality, stability and safety must be similar
- In some cases, generics are 80-85% less expensive than brand-name medications
- In most cases, insurance companies won’t pay for brand-name medications if there is a generic available
Why Do I Have To Wait for a Prior Authorization for My Medication?
- Prior Authorizations (PAs) exist for a few reasons:
- They are used for very expensive medications: $5,000, $10,000 or $20,000 per dose
- They can be used for specific approved uses of a medication
- They can be required if a medication could be abused
- For PAs, the pharmacy works with your provider for the medication to be paid for by the insurance company
- On average a PA takes 7 to 10 business days to be approved
What is the difference between Nation Insurance and Benefit?
- Insurance
- You might have insurance if you are a Ho-Chunk Elder, an employee of the Nation or immediate family of the employee
- If you were given insurance cards that say Auxiant
- Benefit (Uninsured) The Ho-Chunk Nation pays for your healthcare and medications with some help from the Indian Health Service
- You did not receive insurance cards
- You can only get your medications for free if you get them from one of the Ho-Chunk pharmacies
- You are not a Tribal Elder, employee or immediate family of an employee and on their insurance plan
Why Should I Get Insurance?
- Insurance can help prevent having to pay major medical bills if hospitalized
- Insurance can help pay for medications if you are traveling
- Insurance can help pay for medications that Ho-Chunk pharmacies don’t carry
- Insurance can help pay for medications you might need when the pharmacy is closed, like holidays or weekends
Note: Purchased Referred Care (Contract Health) is a payor of last resort. It is not meant to be used long-term
- Contact our Health Benefits Coordinators for more Information
Why Am I Being Asked to Be Seen Once A Year?
- The Ho-Chunk Nation receives medications at a discounted rate as a part of an agreement with IHS
- These medications can only be dispensed to Tribal members who are ACTIVE patients of the Health Department: those who are seen once a year
- It is a tremendous savings to the Tribe if you maintain your active patient status
Note: If you are not seen once every 12 months to remain an active pharmacy patient, you can still use our pharmacy, but you may be responsible for any co-pay or payment of medication
What qualifies as a Health Department visit to be an active pharmacy patient?
Any service within the Department of Health not related to picking up or being given medications
- Medical provider visits
- Dental
- Optical
- Nursing
- Community Health Visits
- Vaccines
- Exercise Physiology
- Podiatry
- Behavioral Health
- Telehealth visits (as allowed by specific service)