How much does your insurance cover for prescriptions?

[starrzone]

How much does your insurance cover for prescriptions?

I am on a university health plan; it costs $250/8 months and covers health, vision and dental. My plan pays 75% of the prescription cost. My father's plan, on the other hand, pays 100% but costs a lot more.

Keep in mind as well that we are in Canada, so insurance is basically only for drugs, eye exams and dental visits, not doctor or hospital visits.

 

[The Mystery Machine]

Depends on the prescription.

Generally after our deductible which is 50. per person per yr., we pay 10% of the negotiated rate.

If it is a maintenence med., generally you are looking at 40/50 per 3 months of meds which have to be sent thru the mail.

 

[BellePrincessBelle]

$10 generic/$15 name brand no deductible no limit

ETA: We pay approx. $50 month for insurance.

 

[daughtersrus]

We do not pay for insurance as it's part of DH's union contract.

We pay $25 for a name brand med and $6 for generic.

There is no deductible.

 

[Papa Deuce]

I don't know... I just paid $60 for 3 months ( total ) for 4 prescriptions. So $5 for each perscription per month is what I pay.

EDIT, that is for most stuff. AFAIK, the max I can pay is $25 per prescription. But this is my wife's plan, now that I have been laid off, so I don't know all the details.

 

[KAMKIM]

My health insurance is $300 a month for the family plan.

Our co pays for prescriptions are 10/30/100 depending on the tier that script falls in. We've never had one for $100 thankfully. Most are $10.

 

[LoraJ]

They used to pay 80%. Now I have to pay full cost until my deductible is met, and then it will be 80% or 70% depending on the prescription.

 

[3boymthr]

We have a three tier program. 100% after co-pay.

$25/Generics
$35/Brand
$50/Non-Preferred Brand

Mail Order is the same co-pay but three months supply of the drug.

We pay 20% of the insurance premium plus an upgrade rate of $36/week to stay with the premium 100% plan which has no-deductible and a $25/office visit co-pay.

 

[DVC Sadie]

I pay 3.00 for generic and the most I have to pay is 22.00 for a 3 month supply of a Caduet.

 

[EthansMom]

Our medical insurance used to cover about 80% of the prescription cost.

A couple years ago, they switched to having us pay for our own prescriptions (at the insurance negotiated rates) in their entirety. That change was done in order to shift some insurance cost increases to the people who use the insurance the most (and are therefore the drivers in premium increases).

We are able to put funds away in either a Health Fund or Health Savings Account so that we can pay for prescriptions with pre-tax dollars.

Not to start a debate or become political, but I've noticed that many people who aren't insured assume that everyone with insurance gets their prescriptions and other health care at no cost or very little out-of-pocket cost. On the contrary, for our "good coverage", my family pays thousands of dollars a year in premiums, we currently have a $5000 a year deductible, and pay in full for our prescriptions. And, considering we have two kids with asthma and DH has needed major surgery in the past year, we feel fortunate that we can afford it.

 

[jen0610]

Starting the first of the year, Prescription drugs will be paid out-of-pocket until the family deductible is reached. Family deductible is $3000.00 per year.

We had to have my sons meds just changed. He is the only one in the family on daily meds. We almost never go to the dr and we have only reached our family deductible 2-3 times since DH and I were married. DS's meds would have run us about $200.00 a month, for a yearly total of $2400.00, which still leaves us short of meeting the deductible.

We just got him switched over to a drug, that is covered by Wal-Marts $4.00 a month plan. It's not listed on the sheet you can find on the internet, but I called and asked about it. Even though it's a controlled med, they have it on the cheap list, but Target doesn't. Sorry, I'm going where I can get it the cheapest.

 

[Feralpeg]

My plan pays about $2.00 on any perscription. It is not a good plan when it comes to perscription coverage. I pay $800 a month to cover myself and my daughter.

 

[apirateslifeforme]

Nothing. Zip, zero, nada. Even after I reach my (single person) deductible of $2900, I would still be responsible for any and all prescription medication costs.

Thankfully, I've only needed one prescription recently - I had strep in June and needed an antibiotic. My grocery store pharmacy was offering free antibiotics at the time, so I got lucky.

 

[LuvOrlando]

We pay 20% per prescription with a cap at $65 and a minimum at $10.
But, if the med is NON-PREFERRED we get the shakedown at 50%. Of course, my DD's Flovent is non-preferred so I pay $65/month for that. I don't love paying more but it is my right to spend out of pocket if I choose to do so. Personally, I will gladly pay more if it means in return I get the right to choose with my Dr what we will do.

 

[Papa Deuce]

BTW, this was 7 years ago, but we had to pay $50 for a shot for my kids... each needed 3 shots, so $300 in total.

I was told by the doctor that the "cost of each shot would have been $1800 - $2500 per shot depending on where they got the medicine, if we were not covered.

 

[antmaril]

Beginning January 1st, no prescription coverage until the family deductible is met - $5,000. We are also losing dental and vision coverage.

 

[Planogirl]

Ours is $35 name brand and $10 generic copays. Plus we go to Wal-Mart and two of our perscriptions fall under the $4 rate they have.

 

[si-am]

Mine is $10 generic, $25 name brand, and $40 "non-preferred." I think everything I've gotten over the past year though has fallen into the "non-preferred" group. I think insurance wants everyone to take penicillin when they're sick, which I'm allergic to. Everything else is more money.

 

[Melmac]

I am also in Canada. I get insurance through work so I don't pay for it. Prescriptions are $2 co-pay each with generic substitutions, if they are available. If I bring my scripts to the pharmacy at work, they wave the co-pay.

 

[tar heel]

Depends on the drug -- might be $10 and might be $200 or more. Our insurance company also will not cover any drug when it deems a cheaper adequate substitute is available. We have spent way over $1,000 this year.

I thought the days of people having low co-pays for drugs were over, but obviously they are not for some of you.