Protecting your physical and financial health
What Is Commercial Prescription Drug Insurance?
If you're suffering from a chronic health condition, you may need a variety of prescription drugs to manage it. Some need them for preventative care, for conditions like diabetes or high blood pressure. You may need help after a surgery or injury. Others need them to manage a chronic health condition, like rheumatoid arthritis or migraines. Whatever your needs, prescription insurance can help you with the costs of these medications.
This is important. Almost a quarter of patients who take prescription medicines have a difficult time affording it. With almost 50% of people in the U.S. taking at least one prescription drug in the past month, the cost of medications are a huge financial burden. There is help.
Commercial prescription drug insurance is a stand-alone product for individuals. It's similar to traditional insurance. You pay a monthly premium and receive copay benefits when you fill a prescription. Often, people get this type of insurance with their traditional medical insurance through an employer or a government program. Others, though, don't have access to these. They need supplemental help to cover the costs of their prescriptions. That's where an insurance plan comes in.
These plans provide benefits for brand-name and/or generic medications. Generic medications contain the same chemicals as the original brand-name drug. They're allowed for sale after the original chemical patents expire. Because of increased competition, generic medications are usually more affordable. In fact, the cost of brand-name drugs can be over 18 times higher than generic options, AARP reports.
Prescription drug insurance plans help you cover the rising costs of many prescriptions. This protects your health as too many people limit or stop using their medications due to cost. It also protects your financial health. With an affordable monthly premium, you can better budget for your ongoing prescription needs.
At Adroit Health Group, we offer stand-alone commercial prescription drug insurance for individuals. Our insurance is underwritten by Envision Insurance Company. This page answers some of the most frequently-asked questions about prescription insurance. Our team is always ready to help you with any of your questions, too.
Our Member Representatives are available by phone Monday through Friday, 7 AM to 6PM (Central). Feel free to give us a call at 1 (800) 269-3563 or send us an email with any and all of your questions.
What Do Prescription Insurance Plans Cover?
In general, prescription insurance provides a few types of coverage. This includes coverage for:
- All medications
- Only generic medications
- A blended plan with generic coverage and the ability to opt-in for preferred brand coverage
Your coverage will further depend on your location. Every state has different insurance regulations.
When you work with an insurance provider, they'll discuss all of the options available to you. In general, plans with higher premiums provide more benefits. More affordable monthly premiums come with moderate copays or benefits, or they may only provide coverage for generic or generic/preferred-brands.
Which one will work best for you depends on:
- Your income and budget
- Which medications you currently take
- Which medications you may need in the future
- Your potential savings
If your condition is stable and responds well to generic options, look at a generic-only plan. This could provide continued savings for a lower monthly premium. Know that you need a brand-name prescription? A generic/preferred-brand plan may work best for you. If you're managing multiple brand-name prescriptions for several conditions, look to more comprehensive traditional medical plans with insurance benefits.
Prescription insurance vs. government and employer plans
Do Obamacare plans cover prescription drugs? Will my Medicare benefits cover my needs? Can I have prescription insurance in addition to my traditional insurance? These are all questions people have about covering the cost of their prescription medications.
In general, all plans under the Affordable Care Act help pay for prescription medications. They're one of the ten essential health benefits a Marketplace plan must provide. However, the exact coverage provided by these plans can vary by state and insurer. Your individual plan will dictate:
- Specific copay amounts
- Which medications are approved for coverage
- Where you can buy your medications
When buying one of these comprehensive health plans, make sure to read the fine print so you fully understand what's covered and what isn't.
For those who qualify, Medicare does offer prescription coverage through their Part D drug plans. Depending on your state and prescription needs, these come with a monthly premium and deductible before your plan pays for covered drugs.
If you have traditional insurance through your employer, check with your plan administrator before applying for Part D or supplemental medication plans. Some employer plans do not allow you to enroll in multiple plans.
What are my other options?
Paying for your prescriptions can be difficult. Nowadays, many people don't have access to traditional employer health plans or government options. Prescription insurance is one of the best ways to bridge this gap in your physical and financial health.
Also talk to your doctor. Every healthcare decision is best done under their care.
Your doctor can work with you to find additional options. For some, a more affordable generic prescription medication could work. Or, your doctor may combine your prescription regimen with other therapies to reduce your dosage or frequency of medications. Incorporating a physical therapy program for severe back pain, for example, could allow you to slowly and successfully reduce the amount of medications you need to manage your pain.
Above all else, don't simply stop taking your medications. Doing so could be dangerous to your health.
If you've been taking a medication for a long time or at higher levels, you'll likely need to taper off your dose. Not doing so, or abruptly stopping them, could lead to your condition worsening or withdrawal symptoms. For example, stopping high blood pressure or high cholesterol therapies could lead to these conditions returning. Even stopping a drug like prednisone, which helps with asthma and allergies, could lead to weakness, vomiting, or diarrhea. Other withdrawal symptoms range in severity from dizziness and headaches to seizures or heart conditions.
Simply put, be safe. Work with your doctor and your insurance providers to find a sustainable solution for your ongoing prescription needs.
How Can Adroit’s Prescription Insurance Help Me?
At Adroit Health Group, we provide innovative and supplemental options for managing your health. We offer two types of prescription insurance plans for individuals and families: generic only and generic/preferred brand plans.
Our generic-only option provides co-pay benefits when you purchase generic medications. Need coverage for a brand-name drug? Talk to our Member Representatives about a generic/preferred-brand plan.
Our insurance prescription plans are a stand-alone, or supplemental, product underwritten by Envision Insurance Company. They do not take the place of traditional medical insurance. Further, they are not ACA-compliant. Instead, these plans give you flexibility and savings where you need it most. With the right plan, you can enjoy substantial savings right at the register.
Once your plan starts, your prescription fills and refills are processed in real-time at the point-of-purchase. Our benefits extend to over 56,000 pharmacies nationwide.
Our prescription discount plan
Some of our members also get additional benefits from our prescription discount plan.
With this plan, you pay a small monthly or annual fee. Then, you receive discounts from over 65,000 pharmacies nationwide, including:
- Rite Aid
These discounts help members save up to 80% on some of their prescriptions. Talk to one of our Member Representatives to determine if a prescription insurance plan or discount card (or both) are most appropriate for you.
Healthcare For Your Future
At Adroit Health Group, we go beyond traditional health insurance. We provide options.
Today's families need healthcare that matches their changing needs. Traditional insurance through an employer's plan isn't always a given anymore. Whether you're a contract or freelance worker, going back to school, or retiring early, our plans let you embrace the flexibility of modern life. Our products can save you money, but they also provide peace of mind when life changes.
No matter what your situation is, our team can find healthcare options that work for you and your family. Beyond prescription insurance, we offer a number of healthcare products in over 40 states. Choose from:
- Dental and vision insurance
- Supplemental health insurance
- Heart attack, stroke, and cancer insurance
- Accident and sickness insurance
- Limited medical insurance
- Short-term medical insurance
- Disability insurance
Our Member Representatives are available by phone Monday through Friday, 7 AM to 6 PM (Central). Give us a call at 1 (800) 269-3563 or send us an email to discuss your healthcare needs. They can calculate potential monthly premiums.
It's time for more peace of mind and flexibility when it comes to your health. Contact Adroit Health Group today to get started.