Pharmacy Coverage

Pharmacy services are available through your companies health insurance plan. Group health pharmacy plans differ among the various insurance companies.   To contain costs the pharmacy programs work within a tiered program:

  • Tier 1 – usually includes generic medications
  • Tier 2 – usually includes preferred brand name medications
  • Tier 3 – usually includes non-preferred brand name medications
  • Tier 4 – usually includes the specialty drugs

Co-pays will be the most affordable and cheapest if using the generic brand of the medication as in the tier 1 group.

As drugs become more specialized and fall into the “specialty” drug tier they become very costly. Ultimate prices will be based on the chosen commercial business insurance that the employer purchases, co-pays will all vary. Some medications will not even be covered.

One of the benefits of being enrolled in a group insurance plan is the ability of the employee to enroll in an on-line prescription program. All that needs to be done is obtain the prescription from the medical provider and send it to the on-line pharmacy associated with the plan. The rest is easy. The employee’s medication will be mailed directly to the home in a timely manner, usually a three month’s supply at a lower cost than having it filled at the pharmacy.

Contact ABP Insurance Brokers
Quick contact please fill out the form below.