Understanding your Marketplace prescription drug coverage

Published on May 7, 2020

All Marketplace plans cover prescription drugs. Fill any prescriptions you got from your doctor and take them as directed. Here are 3 things to know about filling prescriptions:

  • You may have a prescription copayment. A copayment is the amount you owe for each prescription you fill. Copayments are usually between $0 and $50, depending on your insurance plan.
  • Check with your insurance company to see if you need preauthorization (also called “prior approval”). Your health plan may require preauthorization for certain drugs, unless it’s an emergency.
  • Different health plans allow you to get your medications from different pharmacies (called “in-network pharmacies”). Call your insurer, or visit their website to find out which pharmacies are in their network.

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