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Medical Prescriptions Costs - Brand Name Or Generic - Big Bill Costs

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Medical Prescriptions with the Individual and Family plan market


Here we're going to discuss prescription coverage (RX) on the individual and family plan market.  Groups will be much the same, but not quite.

As you may have noticed, the cost of your brand name drugs has been going up even faster than the cost of your health insurance.  In fact, the last rate increase letter from your health carrier sited rising cost of RX as one of the leading factors in their premium increase.  And despite all the noise from Washington, this trend will probably continue.

Remember when your Doctor gave you enough samples to go a month or two?  The Pharmaceutical companies don't seem to market that way much anymore.  Instead, you get the barrage of RX commercials during the evening news.  The thought behind that is that the Doctors weren't pushing their drugs enough, so they have us going in to ask for the drugs from the Doctors.  Pretty smart, huh?  Those commercials during the news hour cost a lot and we're paying for them through our insurance premiums and at the pharmacy.

Consequently, to keep the cost of your insurance plan from going completely beyond your mortgage, your plan will now come with a separate deductible for brand name and non-formulary prescriptions.  And many plans will not even cover the brand and non-formulary drugs.

The question we get most frequently is; what's the difference between Formulary vs. non-formulary.  Formulary simply means that the company recognizes the drug as being effective and therefore covered.  It also means the drug is still too expensive for them to cover it as a brand name drug and they wish to pass more of the cost sharing to the subscriber.

Got a question?  Give us a call and we'll do our best to answer your specific Questions.



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