A Guide to Health Insurance

Navigating the System

Empower yourself as a patient, and learn how to get the most out of your benefits. Each plan is different, so this section of our guide will help you understand what it is that you should look for when you receive your insurance information.  This section will help you navigate the health care system when you need care.

  • 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 order...
  • 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 tablet or an...
  • 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 sharing...