Are Prescription Drugs included?Medical Cost Sharing is designed for those individuals who want to take control and responsibility for their own health-care. They are generally like-minded persons who take care of themselves and lead health conscious lifestyles. As such, dependency on long term pharmaceuticals is not generally compatible with that mindset or lifestyle. Additionally, with the availability of low cost generics and discount programs, Liberty HealthShare has updated its guidelines to help simultaneously bear the most difficult burdens while limiting costs for the membership.
Over-the-counter medications are not eligible for sharing regardless of whether a prescription is written.
Liberty HealthShare currently provides its members access to a pharmacy discount that has multiple tiers for routine prescriptions. The member pays up to $10 for Tier #1, $20 for Tier #2 or $50 for Tier #3 for the designated prescription medications in each tier. A fourth tier is also avialable for prescription medications at the best negotiated pricing. Members do not share expenses for Tier #1,#2 or #3. However members may submit eligible expenses for prescription medications in the fourth tier. Tier #4 expenses are eligible for sharing in the first 45 days after an acute illness at 50% of the at-the-counter cost up to a maximum of $75 per prescription.
Sharing of Tier #4 drugs are not eligible for sharing for maintenance and preventative therapy.
The sharing of prescription drugs is subject to all the provisions of the Sharing Guidelines including the Annual Unshared Amount.
For more information, see the Sharing Guidelines IV-C-18 Prescription Drugs.