Navigating the System / Prescription drugs
How much you will pay depends on where you fill your prescription, what “tier” your plan puts that drug in, and how your plan works.
Which pharmacy you use makes a difference
Learn where you can fill your prescription and where you’ll get the best deal:
Most plans require you to use in-network pharmacies. Other plans allow you to use out-of-network pharmacies, but you’ll likely pay more.
Some plans require you to use mail-order for medications you take regularly. Others don’t require mail…
Navigating the System / Prescription drugs
Price
The main difference between generic drugs and their brand-name counterparts is that generic drugs are typically much less expensive.
Generic drugs are just as effective as brand-name drugs
According to the Food and Drug Administration (FDA), generic drugs work the same as brand-name drugs. Learn more.
A generic version of a brand-name drug will have:
The same active ingredient (the drug listed on the label)
The same strength
The same use indications
The same form (such as a…
Navigating the System / Getting care, what's covered
Hospitals in a network vary by carrier and by specific plan.
For the 2022 plan year, you can review the networks for individual health insurance products here:
Navigating the System / Prescription drugs
Check the formulary
The list of covered generic and brand name drugs (known as the formulary) is different from plan to plan.
Find out which “tier” your prescription is in. Something to watch for is which group or “tier” your medications belong to on that particular formulary. A lower tier means that you will pay less, and a higher tier you will pay more. The tier can make a big difference in how much you pay when you fill your prescription. Learn more about how prescription drug cost…