An Overview of Coverage
Breaking Down Some of the Basics of Health Coverage Formularies and Tiers
Did you know insurance plans have a list of medicines they cover? It’s called a formulary. If your medicine isn’t on that list, you’ll likely have to pay much more out of pocket. Even if the covered drug is on the list, if it is on a higher formulary tier, there still may be higher out-of-pocket costs or other barriers to access. Tiers are the groupings of drugs on a formulary that have different levels of patient out-of-pocket costs.
Before choosing or switching plans, knowing how a plan covers your medicines is important to ensure that you have access to the treatments you need.
Take the time to learn the basics and evaluate your options to make sure you’re choosing the best coverage options for you and your family. There is a lot of information to learn and digest, but we’re here to help.