What is prescription insurance and does it cost different than other health insurance plans?

UPDATED: Apr 17, 2015

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UPDATED: Apr 17, 2015Fact Checked

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Asked April 17, 2015

1 Answer

Not all health insurance policies include coverage for prescription medications. Of those that do, the coverage may be limited to generic brands, or only pay a set amount or fixed percentage of the cost. To supplement your health insurance, you can purchase secondary plans to cover things omitted by your primary coverage. Prescription insurance is one of those supplemental coverages, and can be purchased separately or as a rider, depending on the issuing company and your health insurance provider.

Your health insurance plan uses a list of medications, called a formulary, to determine which drugs are covered by your primary plan. Any medications that are not covered by the primary are your responsibility unless you have prescription drug insurance. Prescription insurance will pay all or part of your prescription costs, depending on policy you have and how it was customized to meet your needs.

Prescription insurance is useful for people who are on Medicaid and Medicare, as well. After your health plan pays the specified amount of coverage, your prescription insurance would kick in to pay most or all of the remainder of the cost. Because of the restrictions of Medicare, supplemental plans such as prescription insurance are encouraged to reduce your out of pocket expenses.

The cost of prescription insurance will vary by state, provider, and policy specifics. Full prescription cost coverage will be higher than partial coverage, and some plans will not allow you to use name brands or require you to pay the difference in cost between name brands and generics. To get the best prescription coverage, purchase from an independent agent or brokerage such as this website, which can offer you plans from multiple insurance companies so you can choose the one with the most coverage and lowest cost.

Answered April 21, 2015 by Anonymous

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