Summary
The article discusses what to do if a medication is not covered by health insurance. It offers solutions like asking for alternatives, requesting exceptions from insurance, and applying for assistance programs to help cover costs.
Key Facts
- Health insurance plans have a list called a formulary that shows which medications they cover.
- Sometimes a medication is not covered, leaving the user to pay the full cost.
- People can try using generic or similar medicines which might be cheaper.
- It's possible to ask the insurance for a special exception to cover the medication.
- Patients can also apply for programs that help pay for prescriptions, like patient assistance and copay programs.
- Some insurance plans require trying cheaper medications first, a process known as step therapy.
- Medications in higher tiers on an insurance formulary typically cost more, but one can request a tier exception to reduce costs.
