A drug formulary is a list of prescription drugs, both generic and brand name that are covered by your plan. A committee of physicians, nurse practitioners, and pharmacists maintain the formulary and the medications are chosen for their safety and effectiveness. Clinical expertise and input is also sought from many other local physicians who are not committee members. The formulary, pre-service authorization parameters, and related procedures are updated as needed when new information becomes available.
So now you know what it is …. Why should you care? People in the United States spend almost $1,000 per person per year on pharmaceuticals. When you think about it… that is a staggering number and you do have some control of what your share of that amount is. Here is where you should begin:
- Make sure your current medications are covered by your plan. At your annual review make sure your agent is reviewing your medications with you. We are human and can forget so don’t let us! There are new rules and restrictions all the time as insurance companies are struggling with the cost of these medications.
- Does the manufacturer offer you discounts? Or if you are on Medicare, are you eligible for Senior Care of Wisconsin or other programs? High cost does not necessary get passed fully to the consumer. There are programs out there that are designed to make medications more affordable. But if you don’t ask, you don’t benefit. Have your agent do some research or ask your pharmacist. They know of programs and discounts and are just waiting for you to ask!
- Be your own best advocate! When you go in for your annual doctor visit don’t be afraid to bring a copy of your formulary. Doctors often do not know the price you pay for your medications but do have a lot of choices in what they prescribe. Look up your current medications before going and speak up! He or she needs to hear what you want and then they can help you to make a decision that is not only the best for your health, but also friendlier on your wallet.
- New prescriptions Some doctors are quick to write a prescription, but then hesitant to stop a medication. Make sure you do your research and ask lots of questions about long term health goals. If you are asking the questions and the doctor doesn’t give you the answers you deserve, then you may want to look at switching doctors. If you are starting a medication that you will have to take for the rest of your life, you are making a BIG investment. Don’t make it lightly!
Information, education and product knowledge are the cornerstones of great agents and we want to be your health insurance agents! Call Diane at Woodhead Insurance Services LLC 544-0058