HIV Antiretroviral Drugs

Prescription drug coverage is an leading but misunderstood benefit. Most health guarnatee plans and absolutely most owner sponsored group plans have a designate drug benefit. In new years designate drug benefits have become more complex.

The significance of designate drugs cannot be doubted. In their best sense, designate drugs have improved quality of life and extended life expectancy. In their worse sense, designate drugs are very costly and their cost has substantially contributed to the rise in health guarnatee premiums. The cost has become so high that many are skipping medications or not even filling the prescription.

Drugs For Hiv

There is ample misunderstanding of designate drug pricing even amoung those insured by an owner sponsored group plan. There are two things that need to be understood. designate drug coverage commonly speaks of tiers and formularies.

Tiers refer to the level of drug purchased. Until recently most group plans used a three tier pricing structure. The first tier is the generic brand. The second tier is the brand name formulary. The third tier is the brand name non-formulary.

The first tier of drugs, the generic, is the easiest to understand and the least expensive. If the consumer purchases a generic brand, they will pay the bottom co-pay. Use of generic drugs does keep the cost of designate drug plans lower.

The second tier is the brand name formulary. A formulary is simply the brand beloved by that particular underwriting guarnatee company. It is beloved because the guarnatee company has entered into a ageement with the drug maker to promote their exact brand to their members.

Be very truthful here. Each guarnatee company will have its own formulary. Consumers often get trapped paying higher co-pays after they change guarnatee companies. The formulary under one guarnatee plan is not the same as another.

An example is the best way to clarify this. A few years ago, before Prilosec became an over-the-counter drug, half of the guarnatee fellowships in Connecticut had Prilosec on their beloved formulary and half had Prevacid. Many clients who switched their guarnatee from one company to another, discovered that the brand they were used to was no longer available to them as a second tier drug. That meant that they would pay a significantly high co-pay because their beloved drub was now a third tier drug or brand name non-formulary.

The third tier drugs have the most costly co-pay. These are comparable drugs but not beloved because the guarnatee company underwriting the plan does not have a contractual arrangement with that drug manufacturer.

As prices have risen over the last few years, many guarnatee fellowships have moved to a 4 tier system. The fourth tier commonly does not have co-pays but is offered to the consumer at a "discount" negotiated by the guarnatee company.

As you would expect, many of the newer and most costly drugs fall into this tier. For instance a 0 Parkinson's drug, if it were on a beloved formulary might cost a consumer a co-pay of - 0 depending on the plan and the state in which the consumer lives. If this drug is considered a 4th tier drug, the consumer can expect to pay a minimum of 0 and perhaps much more.

Even some of the major guarnatee fellowships are now contribution plans that consist of 4th tier options. People are buying these plans because the premiums are lower. Sometimes however, they examine that the price they have to pay for the "discounted" drug eats up all the prime savings and then some. A good health guarnatee agent will check the formularies before switching a client to a separate guarnatee company and run the numbers to make sure this does not happen.

Finally, another kind of tier has been introduced by many guarnatee fellowships as a part of their designate drug programs. It is called mandatory generic. A mandatory generic clause means that if there is a generic equivalent available for the brand named drug your physician prescribed, you must take the generic brand or pay the 3rd or 4th tier price.

Discuss your medications with your doctor. If your physician feels that the generic equivalent is not standard for your treatment, he will write the designate "dispense as written." You will get the brand name drug. You will pay the higher price.

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