Prescription Plans: What They Are and How They Work

The cost of prescription drugs in America has reached staggering proportions. Too often, Americans are being forced to choose between buying life-saving medications and buying food. More and more employers are cutting back health insurance alternatives, and even when insurance is available, it often does not cover medications.

Prescription plans are now being offered to cover the gap. The concept is simple. You purchase the plan, and then buy your individual medications at a significant savings. This allows you to control your out of pocket expenses for prescription drugs. Like everything else in life, there are certain tradeoffs which must be considered when deciding if a prescription plan is right for you. Also, plans vary widely in terms of initial cost; payment options; drugs covered; and net savings. Therefore, it is important to research a variety of plans to find the one that will best meet your needs.

Prescription plans work best for those who require expensive medications. If you rarely get sick, and when you do you generally only need a round of penicillin, you may not need a prescription plan. However, remember that if you do not have one, you are taking a bit of a gamble. Just like health insurance, a prescription plan is something that you may not need, but if you suddenly take ill, you will wish that you had.

Each prescription plan has a formulary, which is a list of the medications that are covered. New and experimental medications tend not to be covered. Be sure to search the formulary for medications you already take or are likely to need in the near future. If your medications are not covered by a prescription plan, you have two options. One is to talk with your doctor to determine whether a covered medication would meet your needs. The other is to pay for that specific medication out of pocket, while using the plan to cover other medications, thereby lowering your total out of pocket expenses. Some new plans are now advertising that they no longer use formularies, but rather discount every single prescription medication. Time will tell whether this is indeed the case.

The market is currently glutted with prescription drug discounters. Finding the best one for your family can be difficult and time consuming. Nonetheless, asking a few basic questions about each program should assist you in your search.

Make sure that the plan you are considering is honored by your preferred pharmacy. It will make your life easier, particularly if you are already taking a number of medications, if you do not have to change pharmacies. Do not simply take the program’s word for it. Call your pharmacy directly and ask if they accept the program you are considering.

If you take certain medications regularly, find out if your prescription program offers mail order service. By changing your regular medications to mail order, you can often receive additional savings.

Compare prices for multiple programs. Monthly fees can vary widely, as can the discounted prices of the medications. Be sure to find out the bottom line, and compare programs accurately.

Many programs offer a trial period, during which you can cancel if you are not satisfied. Be sure to take advantage of this trial period, as advance research is no substitute for actually becoming a member. Read your membership documents carefully, and be certain that the new program works for you.

Because a prescription plan is not insurance, there is no waiting period and no pre-existing condition limitation. Prescription programs work by negotiating bulk prices for medications, and passing the savings along to you. The programs are reasonably priced, and offer a savings on your medications. Unless your existing health insurance covers medications, a prescription plan should definitely be considered.

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