How to Include Prescription Drugs into our Healthcare Plan?

Written By Alla Levin
December 06, 2019

How to Include Prescription Drugs into our Healthcare Plan?

Having a healthcare plan in place is a good way to reduce the costs of doctor visits, exams, and other related costs. Without it, you could be on the hook for thousands of dollars.

However, it is important to know and be aware of their pitfalls. For example, while you might assume that prescription drugs are included in your healthcare plan, that isn’t the case.

This means that even with some types of coverage, you will still be stuck paying out of pocket for prescription drugs. 

And most of the time, these drugs aren’t cheap. As a result, if you rely on prescription drugs or think you will in the future, you need to find a way to include them in your healthcare plan.

But if you are unsure of how to do that, don’t worry, we’ve got you covered. Learn about Medicare prescription drug plans and look at how you can go about getting prescription drugs into your healthcare plan.

Medicare Part D Medicare Part D 

If you simply have original Medicare (Parts A and B), your prescription drugs won’t be covered. You will be stuck paying for everything out of pocket with no assistance.

To include prescription drug coverage in your insurance, you need to utilize Medicare Part D. It is not provided by the government, and is instead provided by private companies that have contracts with the government.

If you want prescription drug coverage by Part D, you need to be enrolled in a certain type of health insurance plan. This can either be a private Medicare prescription drug plan (PDP) or a Medicare Advantage plan (also known as Part C) with drug coverage.

Once enrolled in Part D coverage, you will have access to more affordable prescription drugs. Each plan will have premiums, copay amounts, and potentially even a monthly deductible. 

While this makes it easier to afford prescription drugs, it can still be quite expensive. What happens if your prescriptions are still expensive, even with coverage?  Well, in that case, there are a few things that might help you out. If your bills are very high, you could find yourself subject to a Medicare coverage gap.

Once a certain amount of expenses have been incurred, there will be limits as to how much you will need to pay. You may also qualify for catastrophic coverage, which will also limit how much you actually need to pay for the drugs. Be sure to consult your plan and speak to the company themselves if you have any questions.

Not all Plans are Created EquallyNot all Plans are Created Equally

However, it is important to know that not all Part D plans are the same. Just because one plan gives you cheaper access to a certain prescription drug, doesn’t mean that they all will.

Each plan has its own formulary, which is essentially a comprehensive list of the drugs that are covered. Consulting this formulary will help you see whether your drug is included and thus be attained more affordably. If you look at the formulary of a certain plan and don’t see the name of the drug you need, it is best to move on to another plan.

It is important to keep in mind that these lists may change every single year, so be sure to check the list of your plan frequently to ensure the prescriptions you need are still covered. If not, you could be in for a rude (and very expensive) awakening. Also, the amount that you spend on your deductible or on your monthly premiums can also differ from plan to plan.

Some will cost more per month but have lower deductibles, and vice versa, along with a variety of other payment and cost differences. If you are confused about a plan or its benefits, don’t hesitate to reach out to a professional or the company themselves.

They are always willing to help and will likely answer any sort of question you may have. In conclusion, we hope that this blog post has helped you learn how to include prescription drug coverage in your healthcare plan.

Paying for these drugs without assistance can be expensive, so it is recommended for most people to at least consider if including prescription drugs in your healthcare plan makes sense.

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