Insurance and paying meds

OK- I am a little confused, I am not too well with this whole insurance thing to begin with
I have 2 questions:

My insurance says that if I get generic I pay 15, if it is the 2nd tier 40 and if it is a medicine that there is no generic- 60

I just got a scrip filled it was a generic--- I only paid $5 ... ? this has happened before with an antibiotic that i got, I questioned it then but I am just confused with that. I get the 15/40/60 from my card for RX plans and the actual plan from my insurance

My 2nd question which is more of the one i am concerned about - my insurance will only pay out $300 per a year for me for scrips.......

This medicine's retail value is $115... does this mean that basically i can get this scrip from my insurance like 2 times then start to pay out of pocket?

Thanks for any help on understanding this- sorry for the confusion, I feel like a kid asking cuz I am like it is probably so simple.

if any help I have SRC insurance low benefits.

"A laugh is worth a hundred groans in any market." Charles Lamb
http://www.youtube.com/watch?v=da7StUzVh3s

If you get your scripts filled somewhere with their own plan or flat price for generics, I'm guessing the $5 change is for their plan, not your insurance company. Walgreens automatically puts my generic scripts thru on their plan, so I'll get 3-mo worth of meds for what my insurance co-pay would be for 1 month.

The $300 max payout, IDK. Your guess sounds right, but I hope you're wrong!

Yeah I went to Target they had some sign that said ask about our generics at a low cost!

That is cool

Yeah the insurance I have a funny feeling that is what it means-- the plus side though is the county Pdoc told me last Friday that if my insurance did not cover my meds- they would figure out a way for me to get them-- I just sort want to be prepped if that is the case so I can explain if that happens to where they stop paying.

"A laugh is worth a hundred groans in any market." Charles Lamb
http://www.youtube.com/watch?v=da7StUzVh3s

Yes, if the generic cost less than your plan pays, they are going to charge you the price rather than use your insurance.

I do not think the retail/"actual" cost of meds factors into the equation; one good thing about health care and pharmacy plans is that what one would have to pay retail versus what the insurance company has to pay is different; it's more of a "matching" thing so if you pay $15, they probably pay $15 the whole 15/40/60 thing is a good bet; you get $300 worth of that. So, as you see, finding a place where they do not charge your insurance and you pay $5 "saves" you $5 of your insurance $300.

But, you should look at your plan and how much you are paying for your meds portion; the insurance company has to make money to stay in business; so if your meds do not cost you at least $300 a year, you are paying more than you are getting. If your monthly bill is $10, for example, that you pay for insurance and your medicine only costs $115 if you were to buy it outright, you are giving the insurance company an extra $5 ($10 x 12 = $120) so you should cancel that portion of your insurance, save the $10 a month/find a cheaper plan. My husband just did that with his Medicare and saved us $450 a year!