What is the prescription drug coverage for employer-sponsored health coverage?

Medical care today can be expensive, but those who have health insurance are more likely to seek medical care when they need it. They are also more likely to be protected from unexpected or extremely high medical expenses. Some expenses associated with health care, such as prescription medications, are more regular but often remain very costly. Employer-sponsored prescription drug coverage can absorb some of the costs.

Employer-sponsored prescription drug coverage is often offered as a part of an employee health insurance plan. The specific benefits covered will be described in the schedule of benefits or formulary. Just as group health insurance plans do not always cover all medical expenses, neither do all prescription drug plans automatically cover all prescription drugs. The formulary explains exactly which drugs are and are not covered.

Drugs that are covered are generally referred to as preferred. Preferred medications tend to include generic medications, which often cost less than brand-name medications. You will usually only be required to pay your copayment for medications that are listed on the formulary.

Drugs that are not on the formulary are called non-preferred. These may still be covered but at a lower rate than those that are on the formulary. You may be required to pay a larger copayment or co-insurance amount. Other drugs may not be covered at all, and you will be required to pay full price for these medications if you need to take them.

If you take a prescription medication or several prescription medications, check your formulary to determine whether or not they are covered. If they are not, you may be able to discuss alternative prescription medications with your doctor. You and your doctor may be able to work together to find an affordable solution to maintain your health.

Employee-sponsored prescription drug and health coverage can help you save dramatically on your medical costs. Talk to your human resources department or one of our experienced insurance professionals today to learn more.

Source: Los Angeles Health Care

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