Employee Benefits

When Buying Prescription Drugs, Some Pay More With a Prescription Plan

An interesting article to consider.

It’s not typical, but it can happen. Say you have a prescription drug benefit plan and the co-pay is a fixed dollar amount. It is possible that the full price of the drug or a generic equivalent is less than your co-pay. What should happen is that you are charged the lesser of your co-pay or the full price and most of the time that’s the case, but there are exceptions.

The prescription business is very complicated and getting more so every day. Between the drug companies, the pharmacy benefit managers and the pharmacy chains integrated with the managers it’s hard to tell the actual cost of any drug which can vary widely by where you shop. Add to that all the employer plans with various schemes to manage costs and it becomes incomprehensible to the average person.

So, it always pays to check the best source of the prescriptions you need.

  • Use generics whenever possible
  • Use your mail order pharmacy when appropriate for long-term medication. (Your plan may require this).
  • If you are buying retail, ask the full price of the prescription before you automatically use your plan. This may be especially true for older less expensive drugs. (One drawback of doing this is that your medication use history may not be available to your plan).

Source: When Buying Prescription Drugs, Some Pay More With… — ProPublica

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