Rx Assistance Myths Debunked

by | Mar 18, 2022 | Health Insurance, Member Programs

RX ASSISTANCE MYTHS DEBUNKED

1. Myth: If my prescription gets rejected at the pharmacy, that means it’s not covered.

Truth: This is not always true. A rejected medication is simply a notification for members to reach out to us so we can detect potential savings opportunities.

2. Myth: A patient assistance program is the same thing as a copay card.

Truth: A copay card is run after insurance is billed. This means that insurance pays a portion of the charged amount and then the member is left with a small copay amount. A patient assistance program is an income-based program run by the drug manufacturer. If a member is approved for a patient assistance program, the medication is completely free! It doesn’t even get run through insurance.

3. Myth: Patient assistance programs require a mountain of paperwork.

Truth: MotivHealth’s Prescription Assistance team completes most of the paperwork required to qualify for a prescription assistance program. There is just a small portion of the application that a member must fill out, and then their medication is completely free! Believe us, the paperwork is worth it.

4. Myth: I shouldn’t take anything besides the exact medication that my doctor prescribed.

Truth: Every insurance company has a formulary (a.k.a. an official list giving details of medicines that may be prescribed for various ailments) that they manage, and we manage ours in a way that helps our members lower costs. If we recommend a more affordable medication in place of what your doctor prescribed, that medication will be just as effective.

5. Myth: MotivHealth lowers medication costs by lowering medication quality.

Truth: High cost does not equate to high quality. We use innovative tools to make high-quality medication more affordable. For example, we have programs that work directly with drug manufacturers to get exclusive discounts on high-cost medications. Oftentimes our members qualify for free medications, especially with diabetes or other chronic conditions.

Steps Program Basics


Why Participate: So, you and your covered spouse can earn $1 for each day you walk 8,000 or more steps up to 20 days a month. All incentives earned this way are deposited into your HSA.

How to Participate: Create your MotivHealth member account. Sync an eligible device (Garmin, Fitbit, or Apple) and walk your way to $1 a day.

Who’s Eligible: You, the policy holder and a covered spouse.

Rx Program Basics


Why Participate: Spending $200 or more on prescriptions each month? We can help you eliminate or significantly lower your out-of-pocket costs.

How to Participate: Simply call one of our Prescription Benefit Analysts:
(385) 247-1030

Who’s Eligible: You, the policyholder and your covered dependents.

Prompt Pay Program Basics


Why Participate: Save between $250-$3,000 on out-of-pocket costs on planned medical procedures.

How to Participate: Simply call us before your scheduling your procedure, and we'll help you find a participating Prompt Pay facility / provider.

Who's Eligible: You, the policyholder and your covered dependents.

Price Transparency Tool Basics


Why Participate: Lower your out-of-pocket costs by empowering yourself to take charge of your healthcare.

How to Participate: Our Price Transparency Tool is accessed via your member portal. Simply create your account and click "Find Care."

Who's Eligible: You, the policyholder and your covered dependents with member accounts can access this tool.