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Are Your Prescription Drugs Covered Under Your Insurance?

Jan 16, 2015

Drug Coverage Tips With the health care changes that have been going on, policies may have changed, and the drugs that are covered may have changed too. It does not take much time or effort to see what drugs are covered under your health care plan. Here are some tips to help you find out if your drugs are covered under your health insurance.
  • The first thing you should do is visit the website of your insurance provider to take a look at your health plan’s formulary—or list of covered drugs and medications that includes generic and brand-name prescriptions that you and your doctor can refer to when you need a prescription.
  • Next you should call your insurer directly to find out if there are any drugs that have not yet been added to the formulary.
  • You should also review the benefits and coverage material that you received when you enrolled in your health plan.
The formulary can also affect the cost of your prescription drugs. Medications are separated into three different categories:
  • Tier 1: Generic drugs that are available at a low price.
  • Tier2: Preferred brand-name drugs that have a higher cost.
  • Tier 3: All other drugs, which will have the highest costs.
If your prescription is not on your insurer’s formulary, it does not mean that it is not covered under your insurance. For example, most health care plans offer coverage for drugs that are used to help treat high blood pressure, but not all blood pressure drugs will be listed on the formulary. They may be at a higher cost, but you can still get them under your coverage. To lower costs, your doctor may be able to recommend a similar drug that is on the formulary. Contact Gateway Professional Insurance Services in Vacaville for all of your health insurance needs in California.
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