A medical prescription is a document for obtaining medication or medical procedures following treatment by your doctor.
These are issued by a healthcare professional and often provide reimbursement from health insurance. There are two types of prescription plans, namely, prescription discount plans and prescription drug insurance plans.
Studies reveal that up to 69% of patients abandon prescriptions under co-sharing plans. Both plans enable many people to fill up their prescriptions affordably.
In this discussion, we review the differences between prescription discount plans and prescription drug insurance? Keep reading.
What are Prescription Discount Plans?
As the name suggests, prescription discount plans enable you to get drugs at reduced rates from pharmacies.
Even though these mainly benefit patients with no insurance and needing affordable medical care, anybody can enroll. Typically, there are no limitations even if you have federal or employer insurance.
Additionally, if you have insurance and pay any out-of-pocket, this won’t contribute to the deductible amount.
How it Works
You’ll present the discount card to the drug store when a doctor gives you a prescription. Subsequently, the pharmacist will process your prescription using the prescription discount card.
You’ll then pay a lower cash price instead of the regular copay. Further, you’ll pay a lower bill even if you don’t have insurance. After that, the drug store pays the transaction fee to the discount card company.
Pharmacies can increase their drug sales by having many patients fill their prescriptions at the stores under the discount program.
A prescription discount plan is a vital program for patients whose insurance policies have high copays, limited drug availability, and high deductibles.
You can also benefit if you have no insurance plan and need urgent medical care. In due course, you can commence treatment for your condition and even start therapy.
Medical savings can dramatically shoot up for a big family and your annual deductible amount lowered.
It’s worth noting that your final bill for the drugs will depend on the rate set by the drug store and not on your discount card.
For instance, a prescription for a drug may cost $10 at pharmacy A and $25 at pharmacy B, even when you have the same discount card. If you want to save, you may shop at pharmacy A.
When looking for a reliable prescription discount plan, there are some essential things to keep in mind;
- Check whether the company charges a subscription or membership fee. Most programs such as BuzzRx are free and therefore, great savings options.
- Ensure the card is HIPAA-compliant for the safety of your health data.
- The card should be accepted in a wide network of drug stores. If you have a preferred pharmacy, ask if they can accept the card there.
- Check the availability options for your card. For example, some cards are physical and can fit in a wallet, while others are available in the form of apps with multiple features.
What Is Prescription Drug Insurance?
Prescription drug insurance is typically a form of medical insurance to cover you against the costs of medication. You get to pay a monthly, quarterly, semi-annually, or yearly premium under this program.
The prescription drug insurance covers the following costs upon filling a prescription.
- Copays are out-of-pocket amounts already set in the prescription.
- Coinsurance is a percentage of the prescription charges that you must pay.
- Prescription deductive is the amount to be paid before the policy kicks in. After the amount is settled, then the copay applies.
- Integrated deductible includes prescription and medical charges.
- The out-of-pocket maximum applies for policies that are not grandfathered or grandmothered.
If you have an employer or federal insurance, you may have to pay some out-of-pocket amount when filling your prescription.
Sometimes corporate insurance plans for employees in a company may provide a separate package for the prescription insurance or integrate it with the current medical insurance.
The Original Medicare doesn’t cover prescription drugs for outpatient treatment. However, under Medicare Advantage, you may enroll for a Part D prescription plan or buy a special stand-alone plan.
You can also opt for the prescription discount plan instead of taking extra insurance.
As per the Affordable Care Act (ACA), prescription drug insurance is a mandatory requirement if you get your health insurance through a small-group plan, individual market, or Medicaid.
Large group policies are not mandated to cover the essential health benefits except preventive health care.
If your grandfathered or grandmothered plan doesn’t cover prescription drugs, you can get an insurance prescription plan from insurance providers, advocacy groups such as AARP, or drug companies.
Both prescription discount plans and prescription drug insurance enable patients to get medication affordably from pharmacies. The two programs also help reduce the prescription abandonment rate and improve the citizens’ quality of life.
Despite offering discounts or reduced drug prices, prescription discount plans do not reduce the overall cost of medicare.
They may offer substantial discounts for low-cost drugs; however, you may incur high out-of-pocket charges for high-cost medications.
Therefore, prescription drug insurance is better when considering long-term affordable coverage options.
Prescriptions are costly, and it’s essential to have adequate coverage to afford medication to improve your quality of life. If you cannot fill up your prescriptions at the pharmacy, you can get help from assistance programs. However, it’s essential to have a prescription discount plan or insurance plan in place to avoid setbacks when seeking treatment.