What you can doThere are a couple of steps you can take to stay up to date on what your prescription drug coverage is and to protect yourself in the event of an illness. The first is to educate yourself about your current plan -- make sure you have the most current copy of what's covered and ask your human resources department questions if there are aspects of your plan that you don't understand.
The Department of Labor provides a guide to understanding your health plan, the federal Agency for Healthcare Research and Quality has an FAQ about health insurance and the National Association of Health Underwriters provides a Consumer Guide to Group Health Insurance.
If you notice changes in your plan that require you to pay more for your prescriptions, especially the addition of a Tier 4 that affects the medications you regularly take, find out what the impact is and make your concerns known.
"Go and make noise with your employer," advises Dennis Bryan, a pharmacist in Chicago. "Explain how the higher co-pays are affecting you and see if they are willing to make changes."
Some consumers who were covered by a Kaiser Permanente plan for federal government employees complained about a Tier 4 plan and the plan was changed, so complaining can have an effect.
Making sure you are fully insured in other ways can help prevent financial disaster in the event of high prescription drugs and health care costs. Disability insurance can provide a steady income in the event you don't have group disability and supplemental insurance can cover out-of-pocket expenses for illnesses such as cancer.
Should illness strike, you'll need to stay organized with your health insurance information and your prescription, hospital and treatment bills. If you are too ill to stay on top of this information yourself, enlist a family member or close friend to help you. If you don't stay vigilant, you may find yourself unknowingly exceeding your coverage limits or getting treatment or medication that isn't covered, says Schmidt.
Helpful resourcesIf you're stuck in a tiered prescription drug plan or have hit your prescription drug ceiling, there is help available in the form of foundations and organizations that will either help you with your co-pays or co-insurance or assist you in finding help.