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How to See if Your Healthcare Plan Covers Your Prescriptions

There are many reasons why you’d want to look out if your insurance plan covers your medication prescription. If you’re looking around for a new insurance plan and it’s important to find out if your current medications are covered.

Maybe your healthcare professional just prescribed an alternative medication and you would like to see it before you choose the insurance policy. While this information is searchable, it does require some skill to find it. We will help you through this article.

Whenever doctors prescribe an expensive form of medication, the first thought in your mind is if your insurance plan covers the cost. Or even you would like to understand what tier a drug is in, or whether it is a preferred or non-preferred brand.

You have different options for getting this information. We’ll assist you in understanding where to look for it.

 

Does my new insurance plan cover my prescription?

Follow the following steps to figure out the prescriptions covered under your new Marketplace plan:

  1. Visit your insurer’s website to review an inventory of prescriptions your plan covers
  2. See your Summary of advantages and Coverage, which you’ll get directly from your insurance firm, or by employing a link that appears within the detailed description of your plan in your Marketplace account.
  3. Call your insurer to inquire what’s covered. Have your plan information available. It all available on your insurance card, the insurer’s website, or the detailed plan description in your Marketplace account.
  4. Check out any details your insurance firm sent you for the coverage you have got

 

Summary of Benefits and Coverage (SBC):

This document may be a summary of what the health plan covers. While the formulary doesn’t actually tell you ways much different tiered drugs will cost you, the SBC will outline what quantity your copay is for every tier.

When you’re buying healthcare plans or determining whether to stick or to not stick with your current one, use the formulary and SBC to search out whether a selected medication is covered. Based on an example of a tier 3 medication such as insulin SBC, is to be considered a “non-preferred brand”, meaning that you simply need to pay 40% of the drug’s cost. When choosing a health plan option, it’s important to get one with a cheap premium provider (the amount you buy insurance every month) and also consider which plan has the simplest coverage and possibly the lowest out-of-pocket expenses for your medical needs.

During open enrollment periods (the time people are buying new plans, insurance companies are required to form list of medicines and SBCs available. It’s your right to request a list of medicines for an idea you’re buying.

 

Can I attend my regular pharmacy to urge my medication?

Just like different health plans cover different medications, different health plans allow you to buy your medications from different pharmacies (called “in-network pharmacies”). Call your insurance firm or visit their website to seek out whether your regular pharmacy is in-network under your new plan and, if not, what pharmacies in your area are in-network. You’ll also learn if you’ll get your prescription delivered within the mail.

If you’ve got additional questions, call 800.858.1772 to get the required information.

 

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