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How does a consumer find out what drugs a plan covers?

Health insurers keep lists of which drugs are covered and which are covered at the lowest cost for each of their plans. These lists are called formularies. Drug cost-sharing is often "tiered;" that is, consumers pay less for a generic drug, more for a brand-name drug, and sometimes even more for a non-preferred brand-name drug. Consumers should review the formularies in any plan they select to be sure they meet their prescription drug needs and to know what cost sharing is required for any given drug. For plans that use formularies, statements of benefits and coverage include an internet address for obtaining information on the plan's drug coverage, and the Health Insurance Marketplace will include links to company formularies. Consumers also can call the health insurer for help.

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