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No-Cost Preventive Medications

With all the hype and controversy over the Affordable Care Act, many U.S. citizens don't know what to believe or expect about their future co-pays. Will there be any help with prescription co-pays? Yes -- for a few medications anyway. Some preventive medications may even be available at no cost. Keep reading this article to learn which medications will have a zero co-pay.

What Is a Preventive Medication?

Preventive medications and services, in theory, should help you stay healthy. This article is going to focus on medications that the Affordable Care Act (ACA) requires to be covered at no cost and will be available to individuals in every state. When these medications are prescribed by a network provider, you will have a zero co-pay when you pick them up at the pharmacy.

Preventive Medications for Adults

For adults, the following medications will be available with no co-pay:
  • Aspirin 81 mg to help lower your risk of heart attack or stroke (limited to men ages 45 to 79 and women ages 55 to 79)
  • Immunizations
  • Contraception for women, including:
    • Barriers, such as prescription diaphragm or cervical caps.
    • Over-the-counter (OTC) birth control methods, including female condoms, spermicides, sponges, and other methods that can be bought without a prescription. Some plans will pay for these methods if your doctor writes a prescription for them. This will be up to each individual insurance plan. Male condoms will not be covered, with or without a prescription.
    • Hormonal methods, including birth control pills, rings, injections, and patches. Most generic oral medications will be covered by insurance. Keep in mind that each plan still has some rights to decide which medications to put on their list of covered medications. Some companies will charge a co-pay for the brand-name drug if a generic is available. You will need to contact your insurance company to find out if your birth control will be covered without a co-pay.
    • Intrauterine devices (IUDs), including the services to place them and remove them.
    • Emergency contraception (Plan B® and Ella®) will be covered with a prescription.
    • Sterilization methods approved by the Food and Drug Administration (FDA) for women to permanently prevent pregnancy. Examples include tubal ligation, hysterectomy, or Essure® (a method that places plastic barriers into the fallopian tubes to permanently block sperm from getting to the eggs). Vasectomies for men are not covered under the ACA.
  • Folic acid, 0.4 to 0.8 mg (400 to 800 mcg) daily, up to 250 mg (250,000 mcg) total every six months for women who may become pregnant. This includes some prescription-strength folic acid pills, as well as prescription and some nonprescription prenatal vitamins that contain folic acid.
  • Vitamin D supplements for the prevention of falls. When you are deficient in vitamin D, you can experience muscle weakness and pain. Studies show that taking vitamin D supplements can reverse the muscle weakness and improve balance. With stronger muscles and better balance, your chance of falling and injuring yourself is much lower.
  • The ACA requires that insurance companies pay for prescription medications used to help people stop smoking. Previously, insurance companies were allowed to refuse to cover prescriptions when they were being used for tobacco cessation. This forced people to choose between paying hundreds of dollars for the prescription or continuing to smoke. Now that these medications are considered preventive, they will be free to people who wish to stop smoking. 
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