RxVision Specification

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RxVision

Your Prescriptions. Your Savings. Your Choice.

Overview

RxVision is an AI-powered prescription insurance comparison and medication cost optimization platform designed to help individuals identify the most affordable prescription coverage and medication purchasing options based on their personal healthcare needs. The platform compares Medicare Part D standalone prescription drug plans and individually purchased private prescription drug insurance policies to determine which options provide the greatest financial value based on an individual’s actual prescribed medications.

Unlike conventional insurance comparison tools that primarily emphasize monthly premiums, RxVision evaluates the complete financial picture, including annual premiums, deductibles, copayments, coinsurance, medication formularies, pharmacy networks, coverage restrictions, and projected annual prescription expenses. It also compares prescription cash prices, pharmacy discount programs, pharmaceutical manufacturer assistance programs, and applicable government assistance opportunities to identify additional savings.

Users can enter their prescribed medications, including medication names, dosages, strengths, quantities, and refill schedules. RxVision analyzes these individual requirements against available insurance policies, compares brand-name medications with FDA-approved generic equivalents, and identifies the most economical coverage and purchasing options without compromising access to prescribed treatment.

Through AI-driven analysis, verified insurance information, medication pricing intelligence, personalized recommendations, and ongoing policy monitoring, RxVision empowers individuals to make informed decisions about prescription coverage and medication expenses. The platform prioritizes affordability, appropriate medication access, transparency, privacy, and individual decision-making.

Core Modules

Prescription Profile and Medication Management

Allow users to create personalized prescription profiles.
Support manual entry of prescribed medications.
Support authorized prescription history imports and pharmacy data integrations.
Record medication names, active ingredients, brand names, dosages, strengths, quantities, and refill schedules.
Record prescribing instructions and expected monthly and annual medication requirements.
Support chronic and short-term medication requirements.
Maintain individual medication histories.
Allow users to add, update, and remove medications as prescriptions change.
Identify duplicate medication entries and potential inconsistencies for review.
Allow users to identify medications that must remain brand-name products because of clinical requirements or prescriber instructions.
Support multiple individual profiles for household members.
Protect personal prescription information through encryption and user-controlled access.
Recalculate insurance comparisons whenever a user’s medication profile changes.

Prescription Insurance Policy Discovery and Aggregation

Identify available standalone prescription drug insurance policies throughout the United States.
Include Medicare Part D standalone Prescription Drug Plans (PDPs).
Include individually purchased private and commercial standalone prescription drug policies.
Identify policies available by state, county, ZIP code, and applicable service area.
Maintain an organized database of insurance providers and available policies.
Collect monthly premiums, annual premiums, deductibles, copayments, coinsurance, and applicable coverage limitations.
Identify policy eligibility requirements and enrollment periods.
Track policy effective dates and coverage periods.
Detect newly introduced, discontinued, and modified policies.
Maintain historical policy information for annual comparisons.
Distinguish standalone prescription insurance from prescription benefits included in broader health insurance policies.
Exclude policies that are not independently available for purchase from standalone policy rankings.
Identify differences between advertised coverage and actual policy provisions.

Medicare Part D Intelligence

Discover and compare available Medicare Part D standalone prescription drug plans.
Evaluate monthly premiums and projected annual premium expenses.
Compare deductibles, copayments, and coinsurance.
Analyze Medicare Part D formularies and medication coverage tiers.
Identify preferred and standard pharmacy networks.
Compare retail pharmacy and mail-order prescription pricing.
Identify prior authorization, step therapy, and quantity limit requirements.
Calculate projected annual prescription expenses under applicable Medicare Part D benefit rules.
Account for annual out-of-pocket limits and applicable catastrophic coverage provisions.
Incorporate the Medicare Prescription Payment Plan where applicable.
Identify Medicare Extra Help eligibility information and potential savings.
Compare existing Medicare prescription coverage against alternative available plans.
Track annual Medicare Part D benefit changes.
Identify plans that provide favorable coverage for an individual’s specific medications.
Distinguish Medicare Advantage prescription coverage from standalone Part D coverage to prevent inappropriate comparisons.
Apply the appropriate benefit rules for each coverage year.

Private Prescription Insurance Intelligence

Discover individually purchased private and commercial standalone prescription drug policies.
Identify insurance providers offering independently purchasable prescription coverage.
Compare monthly and annual premiums.
Evaluate deductibles, copayments, and coinsurance.
Analyze medication formularies and prescription coverage tiers.
Identify covered and excluded medications.
Compare preferred and non-preferred pharmacy pricing.
Identify coverage restrictions, annual limits, and exclusions.
Evaluate waiting periods and enrollment requirements where applicable.
Compare private prescription policies against Medicare Part D when the individual is eligible.
Identify policies that provide better financial protection for expensive or frequently prescribed medications.
Evaluate actual policy provisions rather than relying exclusively on marketing descriptions.

FDA-Approved Medication Verification

Require verified applicable FDA approval for every medication included in prescription cost comparisons.
Restrict brand-name and generic medication comparisons to FDA-approved products.
Verify medication approval status through authoritative FDA information sources.
Integrate FDA Orange Book data for applicable generic drug equivalence verification.
Verify active ingredients, strengths, dosage forms, and routes of administration.
Identify FDA-approved generic equivalents for brand-name medications.
Distinguish therapeutically equivalent generic products from other medications used to treat the same condition.
Verify applicable therapeutic equivalence ratings.
Identify discontinued, withdrawn, or otherwise changed approval statuses.
Reverify approval information when generating updated comparisons.
Exclude unapproved medications, unverified compounded alternatives, and products without applicable FDA approval from cost comparisons.
Identify medications whose approval or equivalence status cannot be verified.
Never assume FDA approval based solely on inclusion in a pharmacy, insurance, or commercial pricing database.
Clearly communicate verification limitations.
Apply FDA approval and verification requirements consistently across all core modules, optional plugins, reports, and AI recommendations.

Brand-Name and Generic Medication Intelligence

Compare FDA-approved brand-name medications against FDA-approved generic equivalents.
Identify generic products with verified therapeutic equivalence.
Compare active ingredients, strengths, dosage forms, and available formulations.
Compare brand-name and generic medication cash prices.
Compare brand-name and generic insurance copayments and coinsurance.
Evaluate formulary coverage and medication pricing tiers.
Identify generic medications covered more favorably by individual insurance policies.
Identify brand-name medications that may have more favorable insurance pricing.
Calculate potential monthly and annual savings from eligible generic alternatives.
Identify manufacturer assistance programs applicable to brand-name medications.
Compare eligible brand-name assistance benefits against generic purchasing costs.
Identify coverage restrictions that affect brand-name and generic availability.
Identify medications that must remain brand-name products based on user-provided clinical requirements.
Distinguish FDA-approved generic equivalents from therapeutic alternatives.
Never recommend changing prescribed medication solely because another product is less expensive.
Require appropriate prescriber review before any medication substitution or treatment change.

Prescription Drug Pricing Intelligence

Compare prescription prices across available pharmacies.
Identify pharmacy-specific pricing differences.
Compare retail and mail-order medication pricing.
Evaluate prescription cash prices.
Compare cash prices against insurance copayments and coinsurance.
Identify situations where purchasing a medication without insurance may be less expensive.
Compare brand-name and generic cash prices.
Evaluate pricing differences based on medication strength, quantity, and days supplied.
Identify the lowest verified available price for each eligible medication.
Calculate monthly and annual prescription expenses.
Identify circumstances where cash purchases may not count toward insurance deductibles or out-of-pocket limits.
Explain the financial implications of purchasing medications outside insurance coverage.
Identify pharmacy pricing information that requires additional verification.

Prescription Discount Program Intelligence

Identify available prescription discount programs.
Compare discount pricing across participating pharmacies.
Evaluate program eligibility requirements and restrictions.
Compare discount card pricing against insurance copayments and cash prices.
Identify medications eligible for discounted pricing.
Identify participating pharmacy locations.
Evaluate potential savings for individual prescriptions and complete medication profiles.
Distinguish commercial discount programs from insurance coverage.
Identify restrictions on combining discount programs with insurance benefits.
Explain the potential impact of discount purchases on insurance deductibles and out-of-pocket accumulation.
Identify discount program expiration dates and pricing limitations.

Pharmaceutical Manufacturer Assistance Intelligence

Identify pharmaceutical manufacturer patient assistance programs.
Identify eligible FDA-approved medications and participating manufacturers.
Evaluate income, insurance, residency, and other eligibility requirements.
Identify copay assistance programs for qualifying commercially insured individuals.
Identify patient assistance programs available to qualifying uninsured or underinsured individuals.
Identify Medicare-related restrictions on manufacturer assistance programs.
Compare assistance program benefits against existing prescription coverage.
Track application requirements and supporting documentation.
Identify program expiration dates and renewal requirements.
Estimate potential annual savings from qualifying assistance programs.
Distinguish potential eligibility from confirmed program approval.
Identify alternative assistance opportunities when a user does not qualify for a particular program.

Government Prescription Assistance Intelligence

Identify Medicare Extra Help and applicable eligibility requirements.
Identify state pharmaceutical assistance programs.
Identify applicable federal and state prescription assistance programs.
Evaluate potential eligibility using user-provided information.
Compare potential assistance benefits against current insurance coverage.
Identify application requirements and renewal periods.
Estimate potential prescription savings.
Track changes to program eligibility and benefits.
Distinguish government assistance from private insurance and commercial discount programs.
Identify assistance opportunities that may be combined with insurance coverage where permitted.

Personalized Insurance and Prescription Plan Discovery

Analyze the user’s complete prescribed medication profile.
Identify eligible insurance policies that cover the user’s required medications.
Compare Medicare Part D and individually purchased private prescription policies.
Evaluate policy premiums against anticipated prescription expenses.
Identify policies with favorable coverage for expensive or frequently prescribed medications.
Evaluate medication formularies, deductibles, copayments, and coinsurance.
Identify coverage exclusions and restrictions that could affect medication access.
Evaluate preferred pharmacy availability and pricing.
Compare brand-name and generic medication coverage.
Identify potential savings from cash pricing, discount programs, and assistance opportunities.
Calculate projected annual costs for each eligible insurance policy.
Identify policies that provide the strongest combination of affordability and medication coverage.
Identify coverage gaps and potential unexpected expenses.
Generate personalized insurance and prescription purchasing recommendations.
Explain the financial advantages and disadvantages of each recommendation.
Allow users to establish financial priorities and coverage requirements.
Never prioritize a policy solely because it has the lowest monthly premium.

AI Prescription Cost Optimization Engine

Analyze individual prescription requirements against available insurance policies and medication purchasing alternatives.
Calculate projected total annual prescription expenses.
Compare insurance premiums against anticipated medication savings.
Identify when a higher-premium policy provides better overall financial value.
Identify when a lower-premium policy results in higher total expenses.
Evaluate insurance coverage against cash purchasing alternatives.
Evaluate prescription discount programs and eligible manufacturer assistance opportunities.
Identify potential savings from FDA-approved generic equivalents.
Calculate projected monthly, quarterly, and annual savings.
Compare existing coverage against alternative insurance policies.
Generate multiple cost-saving scenarios.
Identify eligible combinations of insurance coverage and assistance programs.
Rank available options according to projected total cost.
Explain the financial reasoning behind every recommendation.
Identify situations where maintaining existing coverage may be more economical than switching.
Recalculate recommendations when policy benefits, prescription requirements, or medication prices change.
Distinguish verified costs from estimates and potential savings.

Personalized Healthcare Coverage Optimization

Evaluate the user’s stated healthcare and prescription coverage requirements.
Prioritize uninterrupted access to prescribed medications.
Identify insurance policies that cover the user’s complete medication list.
Identify policies that provide favorable coverage for high-cost medications.
Evaluate formulary restrictions and pharmacy access limitations.
Identify medications requiring prior authorization or other coverage approvals.
Evaluate the financial consequences of changing insurance coverage.
Identify potential medication access disruptions associated with policy changes.
Distinguish financial optimization from clinical treatment decisions.
Identify potential coverage disadvantages even when a policy offers lower projected costs.
Provide recommendations that balance affordability, coverage quality, and medication access.
Never independently diagnose medical conditions or determine which medications a person should take.

AI Recommendation and Ranking Intelligence

Generate three distinct recommendation categories:

Best Overall Coverage Match: Identify the eligible policy that most closely satisfies the user’s medication coverage requirements and stated preferences.
Lowest Total Annual Cost: Identify the eligible insurance and medication purchasing strategy with the lowest projected annual expense.
Best Overall Value: Identify the strongest balance of premiums, medication costs, coverage quality, pharmacy access, and continuity of treatment.

Additional capabilities include:

Provide side-by-side policy comparisons.
Explain why each recommended option ranks as it does.
Identify trade-offs between premium expenses and medication costs.
Display uncovered medications and coverage restrictions.
Identify pricing and coverage information that requires confirmation.
Explain the potential financial impact of switching policies.
Never rank policies based on undisclosed commercial relationships, sponsorships, or compensation.
Allow users to review all recommendations before making decisions.

Policy and Formulary Monitoring

Monitor insurance premium changes.
Track annual policy renewals and benefit modifications.
Monitor medication formulary changes.
Identify medications moving between coverage tiers.
Detect new prior authorization and quantity restrictions.
Track pharmacy network modifications.
Identify discontinued insurance policies.
Monitor prescription cash price changes.
Track changes to discount and manufacturer assistance programs.
Monitor applicable government assistance program changes.
Notify users when existing coverage becomes less economical.
Identify newly available policies that may provide greater savings.
Generate updated comparisons when material changes occur.

Financial Forecasting and Scenario Analysis

Forecast annual prescription expenses based on current medication requirements.
Project costs under alternative insurance policies.
Evaluate anticipated changes in prescription utilization.
Model the financial impact of medication price increases.
Compare different pharmacy purchasing strategies.
Evaluate the impact of changes in deductibles, premiums, and copayments.
Calculate potential savings from eligible assistance programs.
Generate best-case, expected, and higher-cost scenarios.
Identify potential financial exposure from uncovered medications.
Compare projected costs of brand-name and generic medications.
Provide transparent assumptions for every projection.
Allow users to modify financial assumptions and recalculate projections.

Cost Comparison and Reporting

Generate side-by-side insurance policy comparisons.
Compare premiums, deductibles, copayments, and coinsurance.
Compare medication coverage and formulary restrictions.
Compare brand-name and FDA-approved generic medication prices.
Compare pharmacy pricing and availability.
Compare insurance purchases against cash prices and discount programs.
Display projected monthly and annual expenses.
Calculate potential savings against existing coverage.
Generate personalized prescription cost reports.
Provide downloadable comparison reports.
Maintain historical comparison records.
Display source information and verification dates.
Provide detailed calculation breakdowns.
Identify estimated savings subject to pricing, eligibility, or coverage changes.
Clearly distinguish insurance costs from medication purchasing expenses and assistance benefits.

Data Verification and Transparency

Prioritize authoritative government, insurance provider, pharmacy, FDA, and manufacturer data sources.
Integrate available CMS Medicare Part D plan and formulary information.
Integrate applicable FDA medication approval and therapeutic equivalence information.
Verify policy premiums and benefit information against official policy documentation.
Verify medication formulary information against current published formularies.
Verify generic equivalence through authoritative FDA resources.
Identify the source of material pricing and coverage information.
Record when information was obtained and last verified.
Distinguish verified information from estimated or incomplete information.
Detect conflicting policy and pricing information.
Identify outdated or missing information.
Maintain historical records of policy changes.
Provide transparent explanations of all cost calculations.
Never represent estimated pricing or savings as guaranteed outcomes.
Prevent unverified information from being presented as confirmed coverage or pricing.

User Privacy and Data Protection

Protect personal prescription and insurance information.
Encrypt sensitive information in transit and at rest.
Provide user-controlled data access and retention settings.
Allow users to review, export, and delete personal information.
Minimize the collection of personally identifiable information.
Restrict access to sensitive prescription and financial information.
Prevent unauthorized disclosure of personal medication histories.
Never sell personal prescription information.
Never use personal prescription information for undisclosed commercial targeting.
Support applicable privacy and security requirements.
Maintain transparent data handling and retention policies.
Require user authorization for external data integrations.

Human Oversight and Decision Authority

Present recommendations as informational decision-support tools.
Require users to review insurance policy details before making coverage decisions.
Never automatically enroll users in insurance policies.
Never automatically cancel or terminate existing insurance coverage.
Never automatically change prescription coverage.
Never authorize medication substitutions or changes to prescribed treatment.
Require explicit user authorization before initiating any supported external action.
Encourage consultation with qualified insurance professionals and healthcare providers when appropriate.
Clearly communicate uncertainty, eligibility limitations, and coverage restrictions.
Preserve the user’s authority over all insurance and medication decisions.

Optional Plugin Modules

Advanced Pharmacy Network Intelligence

Compare pharmacy locations and network participation.
Identify preferred pharmacies for individual policies.
Compare local, regional, and nationwide pharmacy availability.
Evaluate mail-order pharmacy options.
Identify pharmacy access limitations.
Compare pharmacy pricing within individual insurance networks.

Advanced Medication Alternative Intelligence

Identify additional FDA-approved generic products.
Research FDA-approved therapeutic alternatives separately from generic equivalents.
Compare medication pricing across available FDA-approved formulations.
Identify potential savings from alternative strengths or quantities for discussion with a prescriber.
Provide FDA approval and equivalence information.
Require qualified healthcare professional review before any treatment change.
Exclude unapproved products from all cost comparisons.

Insurance Enrollment and Renewal Assistance

Identify applicable Medicare Part D enrollment periods.
Monitor annual enrollment deadlines.
Explain insurance switching requirements.
Help users prepare information for enrollment.
Provide policy application guidance.
Explain potential consequences of changing coverage.
Never submit enrollment or cancellation requests without explicit authorization.

Household Prescription Optimization

Support multiple individual medication profiles.
Compare prescription expenses across household members.
Identify household-specific assistance opportunities.
Generate combined household prescription expense reports.
Maintain separate privacy and access controls for each individual.
Compare available insurance options for each eligible household member.

Advanced Savings Notifications

Monitor prescription price reductions.
Identify newly available discount programs.
Detect new manufacturer assistance opportunities.
Notify users when lower-cost insurance policies become available.
Identify changes that could materially reduce annual prescription expenses.
Alert users when a medication’s formulary status or pricing changes.

Insurance Provider Intelligence

Compare insurance provider coverage offerings.
Monitor policy availability and historical premium changes.
Track provider-specific formulary modifications.
Identify coverage differences between insurance providers.
Maintain provider information and policy documentation.
Identify recurring pricing and coverage changes.

Advanced Prescription Data Integration

Support authorized prescription history imports.
Integrate with supported pharmacy and healthcare data providers.
Import medication information through supported interoperability standards.
Synchronize medication lists with user authorization.
Allow users to review imported information before incorporating it into cost calculations.
Support authorized updates when prescription information changes.

Advanced Medicare Assistance Intelligence

Evaluate potential Medicare Extra Help eligibility.
Identify applicable state pharmaceutical assistance programs.
Compare assistance opportunities with existing Medicare Part D coverage.
Identify program restrictions and eligibility requirements.
Monitor assistance program changes.
Generate personalized assistance opportunity reports.

AI Intelligence and Decision Framework

RxVision must prioritize the user’s total prescription-related financial savings while maintaining access to required medications and respecting prescribed treatment.

The platform must evaluate each available option using the following considerations:

Annual insurance premiums.
Applicable annual deductibles.
Medication copayments.
Medication coinsurance.
Pharmacy-specific pricing.
Formulary coverage and restrictions.
FDA-approved brand-name and generic medication pricing.
Prescription cash prices.
Discount program pricing.
Eligible manufacturer assistance.
Eligible government assistance.
Applicable benefit limits and out-of-pocket protections.
Potential expenses resulting from uncovered medications.
Pharmacy accessibility and network restrictions.
Continuity of prescribed medication access.

Every recommendation must include an explanation of its financial assumptions, coverage limitations, data sources, and verification status.

The AI must distinguish between direct generic equivalents, therapeutically equivalent products, and other FDA-approved therapeutic alternatives. It must never represent different medications as interchangeable without appropriate clinical verification.

Cost Optimization Methodology

The primary comparison metric is the projected total annual cost of obtaining the user’s prescribed medications while maintaining appropriate prescription coverage.

The system must calculate:

Total Annual Prescription Expense = Annual Insurance Premiums + Applicable Deductibles + Prescription Copayments + Coinsurance + Other Applicable Medication Expenses

Calculations must follow the applicable insurance benefit structure and prevent double-counting.

Cash purchases, discount programs, and assistance programs must be evaluated as alternative or supplemental purchasing options where permitted.

The system must distinguish between:

Total annual insurance premiums.
Total annual prescription expenses.
Total annual insurance and prescription expenses.
Potential savings from alternative policies.
Potential savings from non-insurance purchasing options.
Potential savings from FDA-approved generic equivalents.
Potential savings from eligible assistance programs.
Estimated financial exposure from uncovered medications.

The system must account for applicable insurance accumulators and distinguish expenses that qualify toward deductibles and out-of-pocket limits from those that do not.

For Medicare Part D, calculations must follow the applicable benefit structure for the relevant coverage year, including deductible, initial coverage, and catastrophic coverage rules.

For private prescription policies, calculations must follow actual policy terms and applicable coverage limitations.

The AI must never assume that a discount card, cash purchase, or manufacturer assistance benefit counts toward an insurance deductible or out-of-pocket maximum unless applicable program rules explicitly permit it.

Specification Branding License (SBL)

Standard

Fully AGPL-3.0+ compliant system
Copyleft enforced for network deployments
Required attribution:
- Roxanne Ardary
- https://www.roxanneardary.com/

Optional

Specification Branding License (SBL)
- Attribution-free commercial deployment
- Pricing based on scale, usage, and deployment scope
- https://roxanneardary.com/rxvision/

License & Notice Requirements

RxVision is released under the GNU Affero General Public License v3.0 or later (AGPL-3.0+).

By contributing to any Open Arsenal project, you agree that your contributions will also be released under this license.

Please note the following:

All contributions must comply with the AGPL-3.0+ terms.
Under Section 7 of the license, all redistributions, forks, and derivative works must preserve attribution to:
- Roxanne Ardary
- roxanneardary.com
RxVision specifications are free to use with attribution. A Specification Branding License can be negotiated upon request.
The project’s notice.md file tracks attribution requirements and contributor acknowledgments. Any update that adds new contributors or modifies attribution should also update notice.md.
When submitting a pull request, ensure that any new files maintain the attribution headers where applicable.
Network-deployed versions of this software must also remain fully AGPL-3.0+ compliant, including exposure of source code modifications when applicable under the license.

For full legal details, please refer to the AGPL-3.0+ license and the project’s notice.md file.

Notice – RxVision

Attribution Requirement: Under Section 7 of the AGPL 3.0+ license, all redistributions, forks, and derivative works, including network-deployed versions of this project, must provide attribution to Roxanne Ardary and roxanneardary.com.

Contributors

This file tracks contributors and their specific contributions to the project.

Roxanne Ardary, roxanneardary.com – November 8, 2026
Created the repository for RxVision. Developed the initial specification for an AI-powered prescription insurance comparison and cost optimization platform that evaluates Medicare Part D and individually purchased private prescription policies, prescribed medications, FDA-approved brand-name and generic alternatives, pharmacy cash prices, discount programs, and pharmaceutical assistance opportunities to identify affordable coverage and maximize prescription savings.
Add other contributors here – [Date]
[Describe contribution in one sentence]

License – RxVision

This repository is licensed under the GNU Affero General Public License v3.0 or later (AGPL-3.0+).

Key Points:

You are free to use, modify, and distribute the code.
All redistributions, forks, and derivative works or network-deployed versions must also be licensed under AGPL-3.0+ and provide attribution to Roxanne Ardary and roxanneardary.com as required under Section 7 of the license.
The software is provided “as is,” without warranty of any kind.

For the full license text, see GNU AGPL-3.0 License.