How to Get the Best Prescription Insurance — Tier & Policy Explanations

You might have just signed up for your health insurance policy through the Federal Marketplace, but does your healthcare plan include prescription insurance? Or will you need to purchase another supplemental insurance plan? We’ve found all the answers you need before choosing your healthcare plan.

Do you need the best coverage for your medication? Call our agents every weekday from 9 a.m. to 5 p.m. at (855) 968-5736, and we will ensure that you receive the best coverage possible. Want to explore all of your options ahead of a phone call? Our quoting tool gives you the most accurate estimate with plan details.

What is Prescription Insurance?

Prescription insurance is an insurance policy that helps pay the cost of certain prescription medications. Normally, when you sign up for a healthcare plan, it will include medication coverage. Policies will have a formulary, or list of covered drugs, that will tell you exactly how much you’ll pay for the medication.

Prescription Insurance Tiers Explained

Not all drugs are created equally and aren’t priced similarly either. Because of this, healthcare plans separate their drug coverage through different tiers. The higher the tier, the higher the copayment you’ll have to pay before getting your medication.

Depending on your policy, your prescriptions can be separated into three or four tiers. Remember to review your coverage before you enroll in your plan. Or you can contact an insurance agent who will work with you to find the best coverage.

Our well-informed agents are here to help you find coverage with the prescription medication you take. We are available every weekday from 9 a.m. to 5 p.m. at (855) 968-5736. Don’t hesitate to call if you have any questions about your prescription medication coverage.

ACA Marketplace Plans & Prescription Insurance

You’re in luck if you received a healthcare plan through the Federal Marketplace. All ACA Marketplace plans require prescription drug benefits since it is one of the essential health benefits that the ACA covers. The coverage you receive will depend on the plan, so work with an agent to ensure that your medication is covered under your policy.

Our agents are here to help you walk through all the coverage you need at the cheapest price. Call us at (855) 968-5736, and we will help you comprehend all the policy information.

Prescription Insurance Payments

Like a general healthcare policy, prescription insurance payments can be broken into three categories: copayments, coinsurance, and deductibles. Each plan has different terms that define the amount the policyholder must pay before receiving their medication or treatment.

Here’s a breakdown of each category:

Copays

Copayments are set in tiers depending on the plan’s formulary. Prescription medications are separated into different tiers that require you to pay a certain amount before receiving your medication.

Generally, the higher the tier, the more money you’re expected to pay with the highest tier being specialty drugs like injectables or biologics. Each plan is different, so work with your insurance agent to guarantee you get the coverage you need.

Coinsurance

Coinsurance works similarly to copayments. However, instead of paying a set amount, you’ll be paying a percentage of the cost while the insurance provider covers the remainder. Most prescription insurance will have you paying either 20% or 30% of the medication cost.

Contact your insurance provider or agent to confirm how much you’ll pay for your medication. Our quoting tool can also help you find plan details on the Federal Marketplace.

Deductibles

Prescription insurance deductibles are split into two categories: integrated and prescription deductibles. Integrated deductibles are more common as it is a shared deductible amount with your healthcare policy. However, prescription deductibles are separate deductibles that only apply to your medication costs.

You could have either or both of these deductibles depending on your plan. Are you looking for plans with a low deductible? Call our agents at (855) 968-5736 for your best plan.

Stand-Alone Prescription Drug Coverage

Stand-alone prescription drug coverage is a supplemental insurance policy that offers prescription insurance without medical coverage. However, because healthcare coverage usually includes prescription insurance, stand-alone prescription drug coverage is rare unless you are on Medicare.

With Medicare, you can opt into Medicare Part D, known as drug coverage. This optional policy will help you pay for the cost of prescription drugs, recommended shots, and vaccines We highly recommend you pick up a policy as soon as it is available. If you choose to get Medicare Part D outside of your initial enrollment period, you must pay a monthly late enrollment penalty that will increase in price the longer you wait.

Conclusion

Odds are if you signed up for healthcare coverage through the Federal Marketplace, you may already have prescription coverage. Prescription insurance is one of the essential health benefits dictated by the Affordable Care Act, so all plans on the Marketplace are required to offer medication insurance.

However, the coverage you receive, the copayments you need to make, and deductible costs can all differ depending on your plan. If you’re looking for more medication coverage or have a specific prescription you need to pay for, call one of our agents.

They are experts at finding the right policies for your specific needs and situation. We are available every weekday from 9 a.m. to 5 p.m. at (855) 968-5736. If you’re looking for Marketplace plan details, we’ve also got you covered with our free quoting tool. It will give you every plan detail with accurate pricing estimates.

Frequently Asked Questions

Can I Buy Prescription Insurance Only?

Yes, you can purchase stand-alone prescription insurance. However, unless you are eligible for Medicare, finding stand-alone prescription drug coverage might not be worth it since most healthcare plans include prescription insurance.

How Does Prescription Insurance Work?

Prescription insurance works similarly to most healthcare coverage. When you receive a prescription, you can use your insurance at a pharmacy to pay a discounted price. Make sure your pharmacy will take your insurance before you go.

Where Can I Get Prescription Insurance?

You can find prescription insurance through Marketplace plans. Contact an agent at Health Care Plan Quotes to find the best coverage that works for you. Call us at (855) 968-5736 from 9 a.m. to 5 p.m. on the weekdays to connect with an agent.