Changing Prescription Insurance


Prescription coverage is a big part of the health insurance equation, and prescription drug coverage must be chosen with great care. Even if you have great coverage for doctor visits and hospital stays, a lack of sufficient prescription coverage could leave you struggling to pay your bills. When you consider that some prescription drugs can cost hundreds or even thousands of dollars, you can see why insurance is such an essential part of the picture.

Check the Formulary First

  • Every prescription drug coverage plan has something called a formulary, which is a list of medications the plan will pay for. Many plans separate their formularies into tiers, with different copayment and deductible requirements for each tier. Before signing up for any prescription drug coverage plan, it is important to review the formulary carefully and make sure that all your current medications are covered.

Can You Go to Your Local Pharmacy?

  • In order to save money and cut administrative costs, many prescription drug insurance companies are requiring that all prescriptions for maintenance medications be filled through the company's mail order service. This can be a real convenience, but if you would prefer to pick up your medications at the local pharmacy instead, the mail order requirement can pose a problem. The time to find out about any such requirement is before you sign up for the plan.

Find Out What Your Financial Requirements Are

  • Every insurance company will have different requirements for copayments and deductibles, so it is important to understand all of your potential out of pocket costs before changing plans. Keep in mind that a deductible is a set amount of money you must satisfy before the insurance kicks in, while a copayment requires plan participants to pay a percentage of the cost of the medication. A 20 percent copayment may not seem like much when the medication only costs $30, but that same copayment can be devastating when applied to a $1,000 cancer drug.


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