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Prescription Drug 

Pharmacy Benefit Basics

Prescription Drug

When considering a health insurance plan and out-of-pocket costs for prescription drugs, you should know about:

  • Tier Pricing: (Copay plans only.) Each medication is placed in a tier, a numbered level. There is a set copay for drugs in each tier.

  • Deductible: With some of our plans prescription drugs count toward the plan deductible. Once you meet the deductible, the plan starts paying for covered expenses, including prescription drugs.

  • Coinsurance: For lower premiums, some plans include a coinsurance amount (a percentage of the cost you pay) for drugs once the plan deductible is satisfied.

  • Mental Health: Prescription drugs for mental disorders or substance abuse are not covered unless mental disorders and substance abuse is a covered benefit on your plan. This includes prescription drugs for ADD, ADHD, anxiety, depression and others.

Dental Coverage


How to choose the right Dental Insurance

When considering whether to choose a dental insurance or a dental discount plan, you’ll want to think about your needs and preferences.

With a dental insurance plan, you pay premiums, co-pays and/or deductibles, and the insurance pays the remainder directly to the dentist.

Tips for choosing a plan:

  • Estimate your future dental needs. Consider whether you or a family member will need major dental work or oral surgery. Or maybe you just want basic, preventive care like regular checkups and cleanings.

  • Find a plan your dentist accepts. If you have a particular dentist you’d like to continue seeing, check to see that she or he accepts the plan you are considering.
    Visit our Dentist Finder

  • Consider your budget and how much you are comfortable paying. Decide whether you’d prefer to pay premiums and co-pays over time, or pay the full amounts to the dentist all at once.

Reasons to buy Dental Insurance

Your teeth are for a lifetime

  • You’re more likely to visit the dentist if you have dental coverage. Regular dental visits can identify problems before they get painful and costly.

  • When you get regular cleanings and exams — covered at low or no cost under all of our dental plans — you’ll remove plaque, cut your risk of cavities and help prevent tooth decay, gum disease and more serious oral health problems.

Your teeth and gums affect your total health

  • Keeping your gums healthy can lessen the impact of systemic illness, including diabetes and heart disease.

  • Your mouth reflects information about your whole body. Your dentist can identify signs of dozens of medical conditions with oral symptoms, from osteoporosis to acid reflux.

You'll feel and look better

  • You get peace of mind with dental benefits. Rest easy knowing you’re prepared for the unexpected.

  • Maintaining your dental health can improve your overall appearance and boost your confidence. Now that’s a reason to smile!



What does Vision Insurance Cover?

Vision insurance generally covers eye exams, frames, lenses and contacts. Some plans will cover a certain dollar amount every year, and some every two years.


Unlike health insurance, you can think of vision insurance a kind of discount plan. Beyond an annual checkup, you hope you never have to use your health insurance. Vision insurance, on the other hand, helps pay for purchases you know you’ll need to make every year or two — and want to make, since your glasses help keep you stylish!


Is Vision Insurance Worth It?

If you’re someone who wants to get new glasses every year or constantly replenishes contacts and you find a plan that has a benefit maximum significantly higher than the premium you pay, vision insurance will likely save you money and is worth the investment. If you just want to get a pair of reading glasses and keep them for five years, you’re probably better off just paying out of pocket.

Either way, before buying, make sure you understand the terms of your vision insurance plan and make sure you’ll be happy shopping within the limits of what the plan offers.


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