You can call American many things, but don’t call it underinsured. The US Census estimates that a whopping 92% of Americans have health insurance. While seeing medical providers is a critical component of medical care, you also need prescription medication to stay healthy.
If you’re one of the 92%, you may find yourself wondering whether your medical insurance covers prescription drugs. Finding the answer to that question is sometimes complicated, but you don’t need to stress out about it. Read on for a quick rundown about how to navigate your coverage.
Your Formulary Matters
The first thing you need to know is that many health insurance plans do not cover prescription medication directly under their plan. You may have a secondary insurer that covers your prescription medication. If you’re covered under Medicare, this is known as Part D coverage.
If you have the opportunity to select your provider and know the prescriptions you need, then it’s a good rule of thumb to check each plan’s formulary because not all drugs are covered under every medical insurance. The formulary details which drugs the insurer covers and the tier it falls under.
In prescription coverage, tiers refer to the amount of coverage and your copayments. Prescription drugs in tier one are usually generic and have the lowest copayments. Tiers go up to tier four, which are for rare or very serious conditions and have a corresponding high out-of-pocket cost.
Check Your Deductible
It’s very common for medical insurance plans to have a deductible that you must meet before your insurance kicks in. This may also be true for drug costs. In particular, people who have high-deductible plans must pay out of pocket for their medication to meet their deductible, and after that, they are only responsible for their copay.
Save on Prescriptions With or Without Medical Insurance
If you find yourself facing a high deductible or lack of coverage for a particular prescription, that doesn’t mean you have to divest yourself of your life savings to get it.
Many employers offer flexible spending accounts to their employees to help cover their healthcare costs. They take a fixed amount of money from each paycheck and load it into an account. This money goes in pre-tax, reducing your taxable income.
If you don’t have medical insurance, you can still save on your prescription drug costs. Consider ordering your drugs from a Canadian pharmacy online. If you want to stay local, you can try discount programs like GoodRx or join a membership-based bulk store like Costco for below-retail prices.
Don’t Let Prescription Meds Dominate Your Budget
Finding out whether your medical insurance covers your prescription medication is sometimes super complicated. Taking the time to check out the formulary list before you enroll helps you avoid last-minute stress when your prescription isn’t covered. Pair that with an FSA to tackle costs, and you’ll be on your way to a healthier you!
In today’s influencer culture, navigating health and wellness is confusing at best. You need a resource that’ll help you get the best information about your health without influencer spin. Our blog has all of that and more, so be sure to check it out!