The upper limit of ingredient cost for which a third-party payer will reimburse a pharmacy for dispensing certain multiple source drugs (i.e., drugs for which generic equivalents exist). MACs are used by public programs such as Medicaid and by private prescription insurance plans. Although there is no standard list of MAC drugs, often lists for different insurers or prescription programs include many of the same drugs and similar payment limits.
(for prescription drugs) (MAC) - Upper limits which may be established by the Federal government or the Federal Department of Health and Human Services.
BCBSMâ€™s prescription drug program feature, the MAC caps reimbursement for commonly dispensed drugs when there are generic products available.
The MAC sets the maximum reimbursement for commonly dispensed drugs when there are generic products available.
In service organizations, the limit of reimbursement allowed by an agency for the cost of a supply item.
Maximum Allowable Cost (MAC) is the upper limit prices that health plans will reimburse for Generic or multi-source drug products.