On Private Health Insurance Coverage & The Health Insurance Marketplace
FAQs tagged with “Prescription Drug”
- How can I find out if a health plan covers the prescription drugs that I take?
- I know recommended preventive services are updated all the time. Must my insurance cover newly recommended preventive services without cost sharing?
- I take prescription medication and got evacuated from my home because of a natural disaster in my area. I’m far from my local pharmacy and don’t know when I can get back. How can I get my medication?
- I thought prescription drugs were supposed to be covered in all plans, but my plan doesn’t include them. Is that allowed?
- I was denied coverage for my substance use treatment with my insurer saying it is not medically necessary. When I asked for the criteria to determine whether a treatment is medically necessary, I was told this information is proprietary. Is this allowed?
- If I switch plans, how do I make sure the drug I am taking is covered under the new plan?
- My doctor says I need a prescription drug, but it’s not in my health plan’s formulary. I didn’t realize that when I enrolled in the plan. Shouldn’t my plan be required to cover a drug that my doctor says I need?
- One of the reasons I chose my health plan was because my prescription drugs are covered. Can my health plan make changes to what is covered once I’ve enrolled, and how will I know ahead of time?
- What should I do if my plan doesn’t adopt policies allowing patients to obtain prescription drugs not on its formulary, and I have to pay the full price of the drug?
- When I went to the pharmacy to get my birth control, I had a co-pay. I thought all contraceptive coverage had to be free?