You may have insurance that assists you in paying for your prescriptions; here are some key points about how insurance works.

Pre-Existing Conditions

If you are changing to a new insurance provider, know that the company may not be willing to pay for what they call “pre-existing conditions.” For example: While you were on X Insurance, you developed a rare blood disease that required prescription medication. You allow your insurance to lapse. In other words, there is a period of time during which you don’t have insurance. The next company you join, Y Insurance, considers the condition a pre-existing one, and refuses to pay for your medication. This could and does happen. If you can avoid it, do not let your insurance lapse. Keep your X Insurance policy until the Y Insurance policy goes into effect to avoid the pre-existing condition rule.

Co-Pays

Most insurance companies divide their prescription co-payment option into three different tiers. The first tier is devoted to generic drugs. Often, the co-pay for generic drugs is as little as 10 dollars. The second tier is for what Blue Cross and Blue Shield refers to as “preferred brands.” This is often around 25 to 35 dollars. The final tier is for “non-preferred” drugs. These are for those brand names which have a generic equivalent but the patient has chosen to go with brand name, for brand name drugs not used as the first line of treatment, and for those drugs that have an alternative in tier two that the patient has not chosen to use.

Take the time to talk with your doctor and your health insurance company to figure out where you stand on prescription drug benefits.