CoPay Structures

PDMI can accommodate a variety of copay requests, including:

• Copays based on the greater of a dollar amount or percentage of cost basis – PDMI has the ability to apply fixed dollar amount minimum or maximum copays. For example, if the percentage copay is greater than the maximum amount, the maximum amount will apply. If the percentage copay is less than the minimum amount, the percentage copay will apply.
  
• Brand vs. generic copays by dollar differential – PDMI can differentiate brand vs. generic copays by dollar amount. PDMI also has the ability to charge "plus the difference" on products, which is calculated only if the brand has a generic available and there is a MAC price on the generic drug.
  
• Individual and family deductibles – PDMI can track deductibles three ways: individually, at the family level and in combination. We can also maintain different deductible periods (e.g., yearly, quarterly).
  
• Individual and family maximums – PDMI can track maximums three ways: individually, at the family level and in combination. We can also maintain different maximum periods (e.g., yearly, quarterly)