All benefit plans are different, and the prescription coverage you have is based on your specific plan. Most managed care plans do not offer complete coverage for all drugs. Your plan most likely has different levels of coverage for different drugs. Some drugs may not be covered at all. Also, you may pay less for drugs that you purchase at a pharmacy that participates in your plan s network.
Most plans require that members make a copayment when they pick up their prescription.
A copayment is the amount you pay to the pharmacy that fills your prescription. Carefully read your benefit plan contract to find out the amount and type of coverage you have. It is important that you understand your benefits before you go to the pharmacy, so you can make sure you receive the correct amount of coverage. My plan states that I have a different amount of coverage for drugs that are on their formulary than for drugs that are not. A formulary is a list of drugs and supplies that your plan covers.