Is it true not all prescription drugs are covered under the two proposed health care insurance options?
No. All prescriptions are covered. The difference in out-of-pocket costs to you depend on whether the prescription is a Tier 1, Tier 2, or Tier 3 drug. The co-pays per month will be $10 for a Tier 1 (all generic drugs are in this group including generics that are included on BCBS’s “formulary” drug list), $20 for a Tier 2 drug (a brand name drug that is on the formulary list), and $30 for a Tier 3 drug (brand name drugs not on the formulary list). BCBS develops its formulary list regularly based on the evaluations and recommendations of physicians. BCBS explanations of the three tiers along with information about the formulary list are available at http://www.bcbsm.com/home/drug_formulary/drug_formulary_custom_clinical.shtml. There is a quick formulary guide listing the most commonly prescribed drugs as well as a full updated formulary guide available at this site. You can also phone BCBS Customer Service at 1-800-637-2227 to check what co-pay group your prescription falls into.
