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Health Care: Prescriptions
What insurance programs provide access to prescription medications?
Most insurance programs have some prescription benefits. Medicaid covers most prescription medications. Some people have a small copayment for certain prescriptions, but children and pregnant women do not have any copayments.
Medicare Part D has a prescription benefit for Medicare recipients who have elected to purchase Part D coverage. Part D plans are like other insurance plans that have copayments and deductibles. Some plans cover more services than the basic Medicare plan.
The basic Part D coverage in 2007 is:
$265 deductible
Plan pays 75% of drug costs between $266 and $2,400 and Enrollee pays 25%.
Enrollee pays 100% of drug costs between $2,401 and $5,451 and Plan pays nothing.
Above $5,451, Medicare pays 80%, Plan pays 15%, and the Enrollee pays 5%.
This will be adjusted for inflation each year so the specific dollar amounts will change although the percentages paid by the Plan, Enrollee and Medicare will not.
Many, but not all, private insurance policies have prescription drug coverage. Check your policy to determine what coverage your policy provides.
What if I an uninsured and need prescription medications?
There are several programs that help uninsured people afford their medications.
- First, ask your doctor if she can give you free samples of your prescription medications. Many doctor offices get free samples of medications, so they may be able to give them to you.
- Second, theOhio Best Rx program offers discounts on prescription drug costs for many Ohioans without prescription drug insurance coverage who are:
60 years of age or over; OR
under age 60 with annual family incomes of less than 300% of the Federal Poverty Level which is: $30,636 (single), $41,076 (family of two), $61,956 (family of four).
- Third, many prescription drug manufacturers have patient assistance programs that may offer your medications for free or for a reduced fee. Visit the Pharmaceutical Research and Manufacturers of America website or theRxAssist websiteto see if the medications you take are included.
See also the Forms & Education tab of this section for more information.
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