If you have private insurance or a drug plan at work, review your benefits. Talk to Human Resources or your union representative about your benefits.
You should know:
- If your drug plan is open, that means that the insurer will pay for almost any medication your physician prescribes
- If your drug plan is formulary based, that means that the insurer will only pay for drugs that are on its approved list of medications
- What sort of deductible you may have to pay out-of-pocket
Some private insurance plans require that you pay up-front and then apply for reimbursement. If this is a problem for you, ask your insurance company to allow your pharmacy to send the bill directly to them.
If your employee health plan does not cover a certain drug, ask your employer or human resources manager if the company can make an exception. Or, ask your employer if they would waive any cap you may have on your drug coverage.
If you are refused coverage of a medication you are prescribed, appeal. Sometimes the refusal may be the result of nothing more than faulty paperwork. And sometimes insurance companies will change their mind if you ask.
