Prescription Drug Coverage
Prescription drug coverage is an important aspect of overall
health care coverage. This article will briefly discuss the
types of coverage that are available, as well as some things you
should be aware of when choosing a plan.
Most people obtain their prescription drug coverage as a part of
their overall medical insurance plan. Most medical plans include
some form of prescription drug coverage, and some states
actually require employers to include this coverage in the
medical plans that they offer to employees. Whether purchased
independently or in combination with other coverage, the
available types of coverage are similar.
Traditional, or fee-for-service coverage is the most common form
of prescription drug coverage. This type usually has an annual
deductible amount in addition to the amount of the premiums. In
general, the lower the premiums, the higher this deductible
amount will be. This type of policy pays a percentage of your
overall drug bill once the deductible has been met. This
percentage is usually around 80%. This type of coverage usually
requires you to pay for your prescriptions up front, and you are
reimbursed by filing claims. Another aspect of this type of
coverage is that you can choose whatever pharmacy you want to
fill your prescriptions.
Another type of coverage that is available is provided by an HMO
(or Health Maintenance Organization). This is a fairly
tight-knit group of health care providers that furnish health
care on a prepaid basis. The primary difference with this type
of coverage is that you usually pay some form of co-pay amount
for your prescriptions. You are not required to pay the full
amount as with traditional coverage, only the co-pay. Your
out-of-pocket expense may well be the same as with traditional
coverage, but you do not have to pay the entire amount up-front
and file for reimbursement. Another difference with this type of
coverage is that you will be limited to pharmacies that
participate in the HMO.
PPOs (or Preferred Provider Organizations) are similar to HMOs,
but much more loosely associated. Prescription drug coverage
with a PPO will be very similar to that of an HMO - you will
likely pay some co-pay amount for each prescription that you
receive. However, you will have a wider range of pharmacies to
choose from with this type of coverage.
Another type of service that you may see advertised as
prescription drug coverage is not actually an insurance plan.
These are discount programs that, usually for a small monthly
fee, issue a prescription drug card that qualifies you for
discounts on your prescription purchases. This type of service
does not usually cover all of your prescriptions. Depending on
who issues the card, this discount may be limited to certain
drug manufacturers, pharmacies or to certain types of drugs.
While these programs can help if you are without prescription
drug coverage, they should not be considered as a replacement
for insurance coverage.
There are a wide number of choices available to you when
choosing prescription drug coverage. This is true whether you
are purchasing coverage independently or as part of a more
comprehensive medical plan. You can use some of the other
resources available at this site to help you in choosing the
prescription coverage that is right for you.