Prescriptions and Insurance

In addition to preparing for questions at your next doctor visit, there are also some caveats surrounding prescriptions and insurance that you may want to be aware of should your doctor prescribe a prescription sleep aid.

Because there are many generic forms of brand name prescription drugs, pharmacies may not always fill your doctor's prescription for you as prescribed. This depends on your insurance company's policies and plan. To help ensure that you get the prescription medication your doctor intended, you may wish to get a better understanding of prescriptions and insurance, and consider the following options

Generic prescription medications

Primarily, insurance companies want you to try a generic medication first, because they usually cost less. Typically pharmacists will follow these guidelines.

Generally, you first need to fill your prescription with the generic medication. Once you have tried it and it has proven to be ineffective, you can contact your healthcare provider and request the brand name medication. This process is called a "step edit."

Prior authorization

In order to get some prescription medications, you may need your doctor to submit a "Prior Authorization" form to your insurance company. Once you receive prior authorization, contact your pharmacy to fill your prescription.

Consumer programs

There are some instances when your insurance company either offers a very high co-payment, or simply won't cover a brand name prescription. In these cases, you may want to check to see if the prescription drug has a consumer program, offering you savings on your insurance co-pay.