This post is part of our “Ask an Expert” blog series. In this post, Ken Majkowski, Pharm.D and Chief Pharmacy Officer at FamilyWize , explains the prescription drug coverage exclusions announced for 2018. Ken brings more than 40 years of healthcare experience to the FamilyWize team, including 14 years of clinical pharmacy experience in retail, hospital, and home care. Read his full bio here .
As many Americans know all too well, prescription drug coverage is not a given. Each year, drug manufacturers and health insurance companies negotiate the coverage of each medication on the market. Sometimes, the insurance companies decide they will no longer cover a drug that they have covered in the past – and that can come as a surprise when consumers head to the pharmacy.
At the end of this year, Express Scripts and Caremark will be removing more than 80 prescription medications from their formularies (mostly brand name and some specialty drugs).
How to Know if Your Medication Will Be Affected
Express Scripts and Caremark are companies that administer prescription drug benefits for many different health insurance companies. Regardless of the name of your health insurance, it is likely that one of these two companies negotiates your prescription drug coverage. Both organizations have published lists online of the medications that will not be covered in 2018. To determine which company provides your pharmacy benefit, contact your plan administrator.
What to Do if a Drug You Need is Being Dropped
If you learn that you will be losing insurance coverage on one of your prescription medications next year, do not panic. There are definitely steps that you can take to control your costs.
If your health insurance coverage changes in 2018, try not to worry. There are specific steps that you can take to manage your family’s healthcare budget. Visit FamilyWize.org to learn more!
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