The prescription drugs covered can vary from plan to plan. Before you go to a pharmacy to get a prescription filled, check to see if your medication is covered through your plan. Also check to see if the pharmacy you plan to go to is in your plan's network.
Visit your insurance company's website, or call your insurance company directly to get a full list of the medications covered by your plan and a list of in-network pharmacies. The number to call will be on your insurance card.
Tips:
Check your summary of benefits and coverage for an overview about how prescription medications are covered, including:
- Prescriptions filled at out-of-network pharmacies ( non-participating provider )
- Prescriptions filled at in-network pharmacies ( non-participating provider )
- Prescriptions not covered by your plan
- Coverage for generic drugs, preferred drugs, non-preferred drugs and specialty drugs. (Keep in mind your plan may require a fixed co-pay for some medications and a co-insurance percentage for others. (Co-insurance can be costly when paying for specialty drugs, for example.)
- When your doctor prescribes you medication, ask if there is a generic version, it may cost less.
- You can always call your insurance company or visit its website if you have questions about your plan or need help.
Visit HealthCare.gov for more information about filling prescriptions, including:
- What do I do if I'm at the pharmacy to pick up my prescription, and they said my plan no longer covers it?
- Can I get the non-covered drug during the exceptions process?
- My insurer denied my request for an exception. Now what do I do?
