Prescription Drug Information
Prescription Drug coverage can vary from plan to plan. There are usually categories that help define how much you will pay. The categories include:
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Generic Medications
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Preferred Generic
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Non Preferred Generic
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Brand Medications
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Preferred Brands
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Non Preferred Brands
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Specialty Medication
Prescription Drug Coverage
Generic Medications
Generic Medications will always be the least expensive medication. On occasion a manufacturer will raise the cost of a generic medication and that will push the cost up and it will become a non-preferred generic. Most generic medications will have a very low co-pay.
Brand Medications
Brand Medications are an example of the medications we see advertised on TV. Lots of advertisements on TV. These medications are going to be more expensive. Some plans will have a copay or coinsurance for these prescriptions.
Specialty Medications
These medications are often what is termed injectable. An example of
this medication is Humira. These are expensive medications and will usually require co-insurance.
Medication Cost
In group plans and individual plans your Medication cost will be part of your total out of pocket maximum. This is not true for Medicare.
I recommend consumers always double check the retail cost of their medication vs the plan’s copay or coinsurance offer to make sure they are getting the best price.
The reason for this is some medications will have a retail cost lower than the insurance benefit. Not always but it is good to double check.
Medication Research
There are many websites to do your research. You can use Goodrx.com, Cleverrx.com, and Singlecare.com. Most of these websites will offer discounts on medication with a QR code or barcode to be used by the pharmacy. Most also offer mobile apps you can download to your phone for easy access to those discount codes. Goodrx is owned by an insurance agency, so if you sign up for an account you may get solicitation calls.
I have had customers find significant savings using these tools. It is important when you have prescription expenses to do your homework.
If you have a brand medication that is more than you can afford there are additional options:
A. Work with your physician to see if they can help you enroll in a program with the drug manufacturer to lower your costs.
B. Consider looking to Canada for a lower cost of your medication. For clients who have used this resource, they have purchased three months of medication at the cost of one month stateside. The company I have directed clients to for over 10 years is Global Health Management Canada GHMCANADA.COM or you can call them from the US toll free at 1-888-303-6737.
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