How does health insurance cover prescription drugs?

In North Carolina, health insurance is required to cover certain prescription drugs along with other medical treatments and services. The exact coverage varies depending on the individual plan and its coverage rules. Generally, health insurance plans cover prescription drugs that are determined by the state to be medically necessary and those that are approved by the FDA, or the Food and Drug Administration. To use prescription drugs through health insurance coverage, individuals must obtain a prescription from a licensed health care provider. This prescription is then taken to a pharmacy, and the individual will pay any copayment or coinsurance required by their health insurance plan. After payment is made, the pharmacy will bill the health insurance company and the cost of the prescription will be covered if it meets the plan’s criteria. Depending on the health insurance plan, generic drugs may cost less than brand name drugs due to lower copayments and coinsurance. In addition, some health insurance plans may also offer savings programs or discounts on certain prescription drugs, allowing the individual to save money on medications they may need more frequently. If there are any questions about prescription drug coverage or costs, individuals should contact their insurance provider for more information.

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How does health insurance cover prescription drugs?

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