Arizona Prescription Plans
Prescription plans are often obtained separately from traditional health insurance plans however there are some similarities in the way they work.
A prescription plan requires the payment of a monthly premium, as well as a co-payment on any prescriptions that are filled. Each time you need a prescription filled, you must present both the prescription and an identification card (issued by your insurance company) to the pharmacist. To qualify for reduced drug costs, you must visit only pharmacies that are included within the insurance company network—there are no benefits provided if you visit non-participating pharmacies.
Which Drugs Do Prescription Plans Cover?
Prescription plans typically include coverage for most drugs, but depending on the plan, may exclude prescriptions for some or all of the following types of medications.
- Drugs used for weight loss or weight gain
- Fertility drugs
- Medications used to treat erectile dysfunction
- Drugs that promote hair growth, and any other drugs used for cosmetic rather than medical reasons
- Prescription drugs for the treatment of cough, cold and flu symptoms
- Prescription vitamins (however, some plans may include coverage for prenatal vitamins)
- Barbiturates and Benzodiazepines
Many companies offer plans that include a more extensive range of medications, and charge higher premiums for such plans.
Prescription Drug Plan Categories
Insurance companies that offer prescription plans typically separate prescription medications into three categories (however, some plans may include fewer or more categories). Category One includes generic drugs, Category Two includes inexpensive brand name drugs, and Category Three includes the most expensive brand name drugs. Depending on your prescription plan, your doctor may be required to obtain approval before they can prescribe Category Three drugs.
For consumers, each category represents the amount of money they are required to co-pay on prescriptions, with Category One and Two drugs requiring the smallest co-payment and Category Three drugs the largest. The average prescription plan will usually require a co-payment of around 20% for Category One and Two drugs, and approximately 40% for Category Three drugs. Insurance companies issue a document called a Formulary, or Preferred Drug List, which typically includes a list of Category One and Two drugs only.
Prescription plans are most beneficial to people who must take prescription medications on an ongoing basis. Many plans offer mail order services that make the use of maintenance medications particularly convenient, as prescriptions can be renewed online, and the drugs can be mailed to your home by a pharmacy.
Request a quote for an Arizona prescription drug plan and compare your options today.
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