By Consumers For Quality Care, on January 22, 2021
ABC Chicago reports on advice from Consumer Reports about how to avoid high prices on medicine when an insurer drops a pharmacy from its network or doesn’t cover your prescribed medicine.
First, you should check with your insurer as to which pharmacies are in-network. If you don’t use any of the recommended pharmacies, you may end up paying more for your medicine.
Second, make sure the medicines you need are covered by your insurance. Often, middlemen companies, rather than your doctor or your insurance, make decisions about what sorts of medicines will be covered.
“List[s] of drugs that insurers cover are actually decided by middleman companies called pharmacy benefit managers, that when they negotiate deals with drug companies, they may change or even exclude certain medicines from their coverage,” said Lisa Gill, Consumer Reports Investigative Editor.
Finally, make sure that the pharmacy has your latest up-to-date information. These sorts of glitches can stop insurers from properly covering medicines.
Consumers can also ask pharmacists what the lowest cash price they can offer. Independent pharmacies in particular have more leeway than bigger chain pharmacies to negotiate.