Prescription drug prices continue to surge and create a significant financial burden. Prescription insurance covers necessary medications and reduces your out-of-pocket expenses, giving you peace of mind.
Coverage offsets the cost of brand-name and generic drugs, making it easier to afford the medications your doctor recommends.
Access a variety of local pharmacies, chains and mail-order options to find the most affordable way to get your meds.
When you know the lowest cost solution for your medication, you budget accordingly to ensure you don’t go without.
Choose between an insured prescription program, which provides coverage toward medications, or a discount program, which offers reduced pricing on drugs.
Check the prescription drug list, also called a prescription program formulary, to see if your medications are included.
Prescription insured coverage typically involves paying a set amount, called a copayment, or a percentage of the cost of a prescription. Check to see what pharmacy or mail-order options are included.
Many prescription programs include discounted rates for using certain pharmacies or using mail-order. Once your doctor writes your prescription, use your pharmacy look up tool to help determine the most cost-effective route.
Prescription insurance pays a copayment or a set amount, which is part of the cost of a prescription, and may have a deductible or coinsurance included.
You may also have to pay a deductible, which is the amount you pay before your insurance helps pay for your prescription. For example, if your plan has a $200 deductible, you will pay the first $200 of your prescription before your insurance helps pay toward the prescription cost.
Many plans have a coinsurance, which means you pay a percentage of the prescription cost, and your insurance covers the rest. This is usually an 80/20 or 70/30 split, meaning you pay 20% or 30% of the prescription cost and your insurance covers the rest. Many plans with coinsurance require you to pay full price until you have met your deductible, then pay only a percentage of the full cost.
If you decide that a prescription discount program meets your needs, the discount provider will pre-negotiate prices for drugs on their formulary list, and you pay the discounted cost of the medication.
Note: Prescription insurance plans and discount programs do not work together.
adults currently take prescription medicine.
of people cite cost as the top reason for not filling their prescription.
spent by Americans on out-of-pocket prescriptions in 2024.
annual cost of prescription medications in 2022.
*According to study by GoodRx, KFF & Bloomberg News
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Prescription coverage reduces costs and ensures you have access to the medications you need. You can customize your prescription to even having them delivered straight to your door.
How much can you afford for monthly premiums and potential out-of-pocket costs?
Which plan formulary includes coverage for the specific medications you take? You should choose a plan that includes your prescriptions.
Do you need home delivery for your prescriptions or is it more important that you can pick up your medication at a local pharmacy?
Medications marketed under a specific trade name.
Cheaper meds with the same active ingredients as brand-names.
Plans may have preferred pharmacies where you’ll get lower costs.
Many plans offer mail-order prescriptions, which can be cheaper.
These are available without a prescription and aren’t covered by insurance.
Used for non-medical purposes, like hair loss treatment, aren’t usually covered.
Medications not on the plan’s drug list might not be covered or may require approval.
You might still be responsible for deductibles or additional costs depending on your plan’s design.
The cost of prescription coverage depends on several factors, including:
Prescription insurance is a better fit for people who take medication regularly and want to know exactly what they’ll pay each time. It covers a wide range of drugs and offers the convenience of using network pharmacies or mail-order services.
A discount program is a good choice for those who only need medication once in a while and want to save money without paying monthly premiums. This option is ideal if you’re looking for flexibility and don’t need full coverage.
This benefit table should help you decide between whether insurance or a discount plan is right for you.
| BENEFIT | PRESCRIPTION INSURANCE | DISCOUNT PLAN |
|---|---|---|
| Monthly Cost | Yes (premium) | No |
| Predictable Costs | Yes (copay/coinsurance) | No |
| Medication Range | Wider (brand & generic) | Varies by plan |
| Pharmacy Network | Network access (local & mail-order) | Wide acceptance |
| Best for… | Regular medication users, budgeting | Occasional users, price flexibility |
The cost of your prescription depends on the drug coverage of the program you choose and the pharmacy you use. You may pay less at a preferred pharmacy, which is a pharmacy that has agreed to charge you less. You can check the drug list or formulary to see what you’ll need to pay for your prescriptions.
Visit the prescription program pharmacy lookup. Your regular pharmacy may be available, but could charge more than a grocery store pharmacy or mail-order.
Depending on the program you select, there may be a limit or a monthly dollar amount maximum.
Yes, you can get prescription coverage even if you don’t have health insurance.
Yes! There is no set enrollment window for prescription coverage, but if you would like to sign up during the Open Enrollment Period our agents would be happy to walk you through your options.
You may be able to request an exception from your insurance company, but approval is not guaranteed.
This depends on the plan’s pharmacy network, check if they have pharmacies in the areas you visit.