This year’s federal healthcare legislation has made it harder for Americans to afford prescriptions. The Affordable Care Act created new rules that require insurers to cover certain preventive services at no cost, and the Trump administration is also cracking down on some drug manufacturers for allegedly gouging patients by hiking prices. And while many Americans struggle to pay for their prescriptions out-of-pocket.
Prescription drug insurance has become a complicated and confusing issue for consumers. The industry has misled many people into thinking prescription drugs cover them, but they are not.
Drug coverage has become complicated with the rise of health insurance exchanges. Many consumers don’t realize that their coverage doesn’t cover prescription drugs or that they can’t rely on their employer-based insurance plan to cover prescription drugs, even if they have a high deductible.
So what can you do? In this blog post, I’ll review the basics of what you need to know to protect yourself and your family against the risks of being unable to afford prescription drugs.
When you think about your health insurance coverage, you probably assume it’s there. Maybe you have an idea that it covers certain things, but you’re not entirely sure what they are or whether it covers anything important to you. That’s why it’s important to check out the details. Learn more about the different kinds of coverage offered by Medicare Advantage and Medicare Part D plans.
How do prescription drugs work?
If you are an employer-based insurance plan holder, you may wonder if your health insurance covers prescription drugs. You can check the details on your plan’s website, but you may be shocked to learn that you do not have drug coverage.
Most employer plans only cover services that are considered medically necessary. Drugs are not considered medically necessary and, therefore, are not covered.
Your insurance may say that it does cover certain drugs, but it does not cover any medications for chronic conditions. These include high blood pressure, diabetes, asthma, arthritis, migraines, sleep apnea, depression, bipolar disorder, and many others.
Many plans don’t cover the most commonly prescribed medications, such as birth control, antidepressants, and other drugs used to treat chronic conditions.
What are the differences between insurance plans?
To understand how to find a drug plan that works for you, you need to know what’s covered and what’s not.
Here’s a quick rundown of the major types of drug insurance plans that are available:
• PPO plans: These plans are typically offered by the largest companies in the insurance industry and are generally the most comprehensive. They tend to include a large network of doctors and hospitals and are usually the most expensive.
• HMO plans: These plans are offered by smaller companies and are generally the least comprehensive. They are usually cheaper than PPOs but typically only have a narrow network of doctors and hospitals.
• POS plans: These plans are the cheapest and are typically limited to a single provider network.
What does it cost to buy prescription drugs?
Drug coverage has become complicated with the rise of health insurance exchanges. Many consumers don’t realize that their coverage doesn’t cover prescription drugs or that they can’t rely on their employer-based insurance plan to cover prescription drugs, even if they have a high deductible.
Here are some basic facts about prescription drug coverage.
Prescription drugs are often excluded from the term “health insurance” because they are considered “over-the-counter” or “OTC” medications. This means you won’t be able to use your health insurance to cover prescription drugs, and you’ll have to pay out of pocket.
Many employers offer a choice of prescription drug plans that can provide coverage, usually at a lower price than you would pay for prescription drugs out of pocket.
If you don’t have a prescription drug plan, you can still get free medication, usually through your employer. Some states also have programs that help low-income residents afford prescription drugs.
Do I have a good prescription drug plan?
As a pharmacy technician, I see firsthand the problems consumers face when dealing with prescription drug coverage.
I’ve seen customers try to find a plan that would cover their prescription drugs, only to discover that their plan doesn’t cover them at all, and they don’t know where to turn for help.
Another common problem is that most people don’t realize prescription drugs do not cover them. They rely on their employer-based health insurance, which is likely a high-deductible plan.
If you are unsure whether you have good prescription drug coverage, I recommend checking with your insurance provider, asking your pharmacist, or contacting the National Association for Health Underwriters.
Frequently Asked Questions About Creditable Prescription.
Q: How does Credible Prescription Drug Coverage (CPC) help me?
A: CPC helps you by covering prescription drugs for eligible medical conditions at no cost to you or your dependents. You don’t have to pay for drugs, and you can use the drug at any pharmacy.
Q: Can I take advantage of this plan without prescription drug coverage?
A: Yes, you can. If you don’t have prescription drug coverage, CPC will help you.
Q: How does it work?
A: You can call CPC any time for information and to find a nearby pharmacist who accepts Credible Prescription Drug Coverage.
Top Myths about Creditable Prescription
1. Only low-income persons are eligible for prescription drug benefits.
2. Patients must pay a deductible before prescription drug benefits are available.
3. Medicare patients must pay a deductible before prescription drug benefits are available.
4. People with a Medicare drug plan are not required to be covered by a Creditable Prescription Drug Plan (CDP).
5. A CDP must have a deductible and coinsurance amount set by law.
Conclusion
Do you know someone who has trouble obtaining prescription drugs? Have you been unable to get insurance for your prescriptions?
