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What to Do If Insurance Drops Your Medication in 2020
Each year, drug manufacturers and health insurance companies negotiate the coverage of medications. At times, an insurance company may decide not to cover a particular medication that it covered in the previous year. At the end of 2019, Express Scripts and Caremark, the the two biggest pharmacy benefits managers in the US, will remove around 100 medications from their formularies, which will be mostly brand-name and other expensive specialty drugs. Medications such as Viagra, Plavix and Symbiocort were already dropped from coverage in 2019.
Reasons for the coverage denial
You may be denied medication coverage at the pharmacy for various reasons, such as the medication requires prior authorization, you have reached the maximum number of refills, or a generic drug is required for patients with generic-only coverage.
You may sometimes even have to pay for the covered medications
Covered medication doesn’t mean that your insurance will pay in full for all your medications. There could be deductibles on your plan that have not yet been met. Your plan may expect you to pay the full deductible before it contributes to your medication costs.
Medications are further divided into tiers. If your medication related to heart or lungs problems, sexual dysfunction, acne, weight loss, or other medical conditions that is chronic and requires significant expenses every month is moved to a higher tier in 2020, it will impact your share of the prescription medication costs. Higher the tier more will be your out-of-pocket expenses through co-pays.
Your provider might have negotiated with some network pharmacies to serve you in your plan. If your pharmacy becomes out-of-network, your insurance may not pay towards the prescription medication. Additionally, your plan may also limit you to the first refill only, and require you to use a mail-order for all other refills.
Recommendations to save on coverage-dropped medications in 2020
If you find yourself in a situation where your insurance drops your medication, or the out of pocket cost of the medication is too high than what you expected, you can still save on prescriptions with the below recommendations.
- Consult with your doctor about alternatives
There could be a generic equivalent for your branded medication which could be just as effective. Moreover, there could be alternative medication for your condition that is covered and can be substituted. Consult with your doctor to determine if there is a fomulary alternative for your prescription.
- 90-day supply
Often a 90-day supply of medication may be less expensive then a 30-day supply.
- Patient Assistance Program
Patient assistance programs or manufacturer coupons may be available for your medication and can be helpful in reducing the cost of expensive medications you need.
- Ask for an exception
If the medication you need is on your plan’s formulary but it is high-tier or non-preferred, you can ask your insurance company for an exception. If your request is approved, you can save money for your prescription medication by getting the price down to that of a lower tier medication.
- Check drug prices
Drug prices are not fixed; different pharmacies charge different prices for the same medication. Often, you may be able to get your prescription with a drug discount card for less then your copay. You can check drug prices online at www.ezrxdrugcard.com for the lowest prescription drug price to save on prescription drugs.
- Sign up for EzRx drug card
Download your FREE EzRx drug discount card at www.ezrxdrugcard.com to get instant savings on your prescriptions. When the pharmacists will enters the EzRx drug savings card details, your prescription will be discounted immediately as the card has all the information needed by the pharmacy’s computer for prescription medication savings including discount on Albuterol inhalers, Adipex (Phentermine) savings and flu vaccine savings.
Who can get EzRx drug card
Anyone is eligible to get the EzRx Drug medication savings card such as Albuterol drug discount card, Adipex discount card, flu vaccine discount card and Benzonatate discount card.
EzRx drug discount card can especially be useful for the seniors as well as those enrolled in Medicare as they may lack comprehensive medications’ coverage. With EzRx digital drug savings card, one can save anything ranging from 10% to 85% on various brand-name and generic medications across 65,000+pharmacies all over the USA.
EzRx Savings Card is FREE
EzRx does not collect personal information and everyone is eligible regardless of income or immigration status. There are no upfront fees to save on meds with your EzRx prescription medications savings card as it is Free to download. Anybody can apply for the EzRx prescription savings card irrespective of their age and income. EzRx prescription savings card can be shared with family members and friends as well.
To get your pre-activated EzRx digital drug savings card, simply text the keyword “EZRX” to 21000 or download your card here.
Disclaimer: The information and content posted on this website is intended for informational purposes only and is not intended to be used as a replacement for medical advice. Always seek medical advice from a medical professional for diagnosis or treatment, including before embarking on and/or changing any prescription medication or for specific medical advice related to your medical history.