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What To Do If Insurance Drops Your Medication in 2018

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.

Express Scripts Drug Exclusions 2018

CVS Caremark Drug Removals and Updates 2018

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.

  • Research the cost of your medication at different pharmacies in your area – Not all pharmacies charge the same thing for individual drugs. Visit the FamilyWize Drug Price Lookup Tool . In just a few minutes, you’ll see how much your medication costs at the different pharmacies in your area.
  • Speak to your doctor and pharmacist about your alternatives – There may be a generic equivalent or therapeutic equivalent drug that could be just as effective as your original medication, while saving you a lot of money.
  • Sign up for a free prescription discount card – To date, FamilyWize has helped over 10 million Americans save more than $1 billion on their prescription drugs, regardless of their insurance coverage. Signing up for the card or downloading the FamilyWize app is a quick and easy way to make sure you are trimming as much money from your pharmacy bill as you can.

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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