What typically occurs during the initial coverage stage of prescription drug plans?

During the initial coverage stage of prescription drug plans, a cost-sharing structure is in place where the plan covers part of the medication costs, while the member is responsible for paying a portion of these costs, typically in the form of coinsurance or copayments. This arrangement encourages members to actively participate in managing their prescription drug expenses while benefiting from the insurance coverage provided by the plan.

In this stage, the member does not pay the full price for their medications, as would be the case if they were to pay entirely out of pocket. Instead, the member’s out-of-pocket expenses are reduced due to the part of the costs covered by the plan, which promotes access to necessary medications. The other scenarios do not reflect the typical structure of the initial coverage stage where shared costs exist, ensuring that members receive some benefits from their prescription drug plans.