Insurance

Coverage for Prescriptions: Regular, Medicare and Medicaid

Insurance to cover the cost of prescription drugs is a major concern. The primary sources are private insurers, Medicare, and Medicaid. Due to variation in plans and the high cost of prescription drugs, you are likely to pay out-of-pocket for some portion of your needed prescription medication, regardless of your insurance plan. However, depending on your circumstances, you may qualify for assistance to pay for prescription drugs.

Private Insurance Plan Coverage for Prescription Drugs

Private insurance plans generally provide coverage for prescription drugs. However, coverage under these plans varies widely regarding the types of drugs covered, as well as the co-payment amount for which you're responsible. These plans can vary depending on whether the insurance is purchased through a small business, as part of a group health plan, or individually.

Prescription Drug Coverage Is Available Under Medicare Part D

Medicare recipients are entitled to prescription drug coverage under a prescription insurance plan commonly referred to as Medicare Part D. Under the plan, established in 2006, you receive this coverage through a private company approved by Medicare. The approved companies offer a variety of Prescription Drug Plans (PDPs) from which you select the plan that best fits your needs in terms of the type of prescription drugs offered, the annual premium payment, and the amount of any co-payments.

Medicaid Provides Some Prescription Medication Coverage

Medicaid, run jointly by the federal and state governments, provides prescription drug benefits for low-income, aging, or disabled persons. Even though states are not required to do so, all states provide some sort of coverage. The type of prescription drugs covered and the amount of any co-payment is determined by each state.

Assistance Is Available

Regardless of your prescription insurance plan, it's possible that you can't afford your medication due to the cost of the deductible, the co-payment, or the fact that a particular medication isn't covered under your plan. In these situations, there are other programs available to fill the prescription drug coverage gap in you plan. For example, the pharmaceutical industry runs the Partnership for Prescription Assistance to promote information on programs to help qualified patients receive needed medication.

An Insurance Lawyer Can Help

The law involving prescription insurance plans is complicated. Plus, the facts of each case are unique. This article provides a brief, general introduction to the topic. For more detailed, specific information, please contact an attorney that specializes in insurance law.

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