Are Inhalers Covered By Insurance? Every Health Plan Is Different
An albuterol inhaler can run those who suffer from asthma between $30 and $80 without insurance, depending on whether it’s a brand name or generic version, and whether you have a coupon or discount of sorts. While those prices aren't necessarily astronomical, treating asthma — a very common childhood breathing condition — can get very costly, very quickly. And because it’s such an expensive disease that requires constant care, the best way to save money on treatment is to implement your health insurance coverage to foot some of the bill. But, like almost every American knows, health insurance can be very confusing with nonsensical fine print, so it’s not always clear what's covered sometimes. And considering the fact that millions of Americans have been diagnosed with asthma, wondering whether inhalers are covered by insurance is a common and understandable concern.
Fortunately, though, many plans do cover them, especially if you can use a generic brand. But you’ll have to work very closely with your doctors and insurance company to make sure you know exactly what you’ll be paying and which medication you can take to manage your asthma.
The tricky thing about health insurance is that there are so many different plans out there, and, along with the pages of medical and legal jargon, knowing the ins and outs of your plan can make everything a lot more complicated. But whether you have it through the Affordable Care Act — also known as Obamacare — or your job provides coverage for you and your family, you will need to call the 1-800 number on the back of your insurance card and ask them if your specific asthma medication — such as Ventolin, or long-term controllers like Advair, Singulair, and Flovent — is covered under your plan. If not, see if your doctor can prescribe a different drug with the same ingredients that falls under your plan.
Typical copays can range from $5 for a generic version inhaler to $50 for a brand name. According to CostHelper.com, some brand names for fast-acting emergency inhalers include Accuneb, Ventolin HFA, ProAir HFA, and Proventil HFA; Another common generic drug is known as Salbutamol. For long-term controllers (Advair, for example), the price can vary as well, though remember that those shouldn't be used as emergency inhalers.
But, what if your insurance company doesn't cover the specific medication or dosage your doctor has prescribed? Here's what Lacie Glover, health writer for NerdWallet, advises people with asthma to do in that unfortunate situation:
After you've done that, feel free to take a well-deserved nap.
The first and best way to know whether your insurance covers asthma inhalers is to simply call and ask your health care provider. If you get into a tricky situation, don't hesitate to talk with your doctor about what the best course of action is to make sure your asthma is manageable and your treatment is affordable.