What must a consumer check regarding drug coverage in a new plan?

When considering a new health plan, it is essential for consumers to verify whether their current medications are included on the plan's formulary. The formulary is a list of prescription drugs that a health insurance plan covers, and it specifies which medications are available at what tier of cost-sharing. This means that if a medication is on the formulary, it is likely to be covered at a lower out-of-pocket cost to the consumer, making it a crucial aspect of evaluating a plan.

If a consumer does not check the formulary, they risk finding out that their necessary medications are either not covered or are available only at a much higher cost under the new plan. This could lead to unexpected expenses or disruptions in their treatment, making it imperative to confirm that their medications are included in the coverage before making a switch. This step ensures that consumers can effectively manage their health care needs and budget accordingly.

Other factors, such as the introduction of entirely new medications by a plan, the extent of advertising, or a money-back guarantee, do not directly impact whether a consumer will have access to the specific medications they depend on, which is why they are less critical to check.