Understanding Your Drug Plan’s Formulary

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Between the early 1990s and today, the number of prescription drugs sold in the United States increased by over 37%. There are drugs for almost any medical issue, from heart disease to hair loss — and there are new ones being introduced all the time.

These drugs have made it possible for people to live longer and healthier lives. But they come with a hefty price tag. That’s why people buy prescription drug coverage.

Any insurance plan is going to come with limitations. When you buy a prescription drug plan, some drugs won’t be covered by it. The list of drugs that a plan will cover is called a “drug plan formulary.” If you rely on prescription medications, you should read the formulary of any plan you’re considering before you buy it.

Why Plans Have Formularies

Wouldn’t it be nice if every drug plan paid for every medication on the market?

Things aren’t that easy, though. First of all, there are drug companies to deal with. Each company spends millions — if not billions — of dollars researching new drugs. So when they come up with a winner, they’re eager to make that money back. Meanwhile, insurance companies are looking to negotiate the best possible price for that drug. And you’re looking for an insurance plan that covers the drugs you need and passes savings on to you.

The end result: insurance companies end up offering carefully-created drug plans that try to keep everybody happy.

What If You Can’t Find The Right Formulary?

If you rely on several prescription medications, you may have trouble finding a plan that will cover all of them. If that’s the case, talk to your doctor.

Many plans exclude brand-name drugs, but cover the generic version. You shouldn’t just run out and change the medications you take, though. Before you make a decision about generic drugs, talk to your doctor.

And before you consider changing coverage, you should talk to professional insurance agents and see what kind of coverage options are available. Fill out our simple online form, and you’ll be contacted with free quotes. Our network of licensed insurance agents can help you compare drug plans and make an informed choice.