Identifying a health insurance plan that meets one’s personal needs is difficult as is. However, with the constant limitations of coverage placed on “pre-existing conditions,” finding adequate prescription coverage in a plan can make the search increasingly tricky. If one is able to get approved for medical coverage, it is important that they understand the benefits available to cover their prescription medications.

Insurance companies will typically incorporate prescription coverage that is tier structured. Most generic drugs fall under the first tier, and will usually have a $10-$15 copayment. Preferred brand name and non-preferred drugs will also have a copayment ranging from $30-$50, BUT will be subject to a prescription drug deductible. This deductible is separate from the major medical deductible, and must be satisfied in order for the copayment benefit to go into effect.

Furthermore, insurance companies implement a maximum benefit on their prescription drug coverage. It is not unusual to see this benefit capped anywhere from $2,500-$5,000 per calendar year.
If an individual is worried about the prescription benefits offered by a plan; namely, how one is going to afford their prescription drugs (or the deductible) – consult your doctor to see if there is a generic equivalent. Almost 85% of preferred name brand drugs have a generic counterpart, and frequently price out under the generic copayment.