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PEAK · Plan Selection & Sales Strategies

Prescription Strategy

A plan can look excellent medically while the drug coverage makes it the wrong fit. Verify before you recommend.

Medical benefits can look excellent while the drug coverage quietly makes the plan wrong for this client. Prescriptions deserve their own careful pass.

Verify Current Medications
Check Formulary
Check Tier
Check Deductible
Check Monthly Cost
Check Pharmacy
Check Restrictions
Compare Plans

What "verify medications" actually means

Correct medication Brand vs. generic Dosage Quantity Days supply Tier Drug deductible Monthly cost Preferred pharmacy Prior authorization Step therapy Quantity limits Coverage status

Example

Same medication — Plan A~$10 / month
Same medication — Plan B~$35 / month
Ask "If everything else were similar, which plan would make more sense for someone taking this medication every month?"

Prescription cost differences can become a completely legitimate selling point — when they're verified, not assumed.