Health insurance usually includes coverage for prescription drugs. Prescription drug plans are often divided into benefit levels. The levels are determined by the insurer and may vary from one insurance company to another.

Level one is for generic drugs and low cost brand name drugs. Generic drugs usually have the lowest co-pay, the amount the patient must pay out of your pocket when they have the drug filled. A generic drug is formulated from the same chemicals as the brand-name drug, but they are less expensive. Therefore the insurance company encourages you to purchase them by making the co-pay lower. In addition, many times any prescription deductible is waived by some plans.

Level two are drugs that are the preferred brand name or a high cost generic. Sometimes a drug is still under patent from the company that created it and only the brand name is available. If there is more than one brand name available for a drug your insurer may place their preference on this list. The co-pay may be higher than for level one generic or brand name drugs.

Level three are brand name drugs not selected by the insurer or drugs with a less expensive generic. Therefore it is likely that the co-pay will be higher to discourage their use. These drugs might be referred to as non-formulary, simply meaning they are not on the list of preferred drugs.

Level four on prescription drug plans is usually reserved for specialty drugs. These may include self-injectables, experimental drugs, and high-tech medications. These drugs may or may not be covered by the insurer. Drugs in this category may require high co-pay or even a percentage that must be paid by the patient.

If your doctor has written a prescription for a drug with higher co-pays, the pharmacist may be able to contact the doctor's office to request permission to substitute a drug that will cost less for the patient.

There are drugs that are not usually covered by a prescription drug plans. These drugs might include drugs for weight loss, hair growth or drugs with a cosmetic effect, such as prescription skin creams to reduce wrinkles for example.

There are some prescription drug plans that are only a discount card. This kind of plan lets you save money on prescription by presenting the card at the time of purchase. This is not prescription drug coverage as offered by a health insurance plan. There are no co-pays. The patient must pay the cost amount of the drug minus any discount.

To avoid any surprises at the pharmacy cash register confirm with your insurer which level your drugs fall into so that you can be prepared with your co-payment.