Ohio health insurance companies divide all drugs into categories (tiers) based on cost and use. “Generic” drugs are the least expensive type of prescription. They typically cost between $3 and $10 and are available from most pharmacies in the state, including Walmart, Target, major grocery chains, Walgreens and CVS.
Preferred drugs don’t have a generic equivalent, but they still tend to be fairly inexpensive. They may cost between $10 and $40, depending on the condition that is being treated. Tier Three options are more expensive and are not very common. But they are more expensive than generic and preferred alternatives.
Specialty drugs are the most expensive. Usually they are used with very serious medical conditions that involve a very specialized (and sometimes radical) type of treatment. A few examples are treatment for cancer rejection or rheumatoid arthritis. Your copay and/or coinsurance will tend to be fairly high for this type of prescription.
By purchasing medicines directly through the mail (mail order), often your out of pocket costs will reduce. Most major insurers offer this feature and the savings can be substantial, especially if it is an ongoing purchase. Home delivery is convenient and usually the drugs are delivered every 90 days.
Most Ohio health insurance plans (either current or through the Exchange after 2014) provide mandated prescription benefits. Although the copays may differ, there is no annual or lifetime cap, which is extremely important if you are taking an expensive medication.”Platinum” policies will have the best benefits.
Please call or email us if you have concerns or questions regarding RX benefits on an existing policy or new health insurance coverage in Ohio that you intent to buy. We can explain which plans will offer the most coverage for your prescriptions but at the lowest cost.