Ask Your Pharmacist to Pay for Prescriptions in Cash
You might think that your insurance is offering the best prescription prices at your local pharmacy, but it turns out that this may actually increase your out-of-pocket expenses thanks to the prescription “plug rule.”
This is because pharmacists work with Pharmaceutical Benefit Managers on the terms of your prescription costs. And in some cases, these prank rules included in contracts prevent your pharmacist from telling you that the drug you want to buy could be cheaper if you paid for it in cash instead of buying it through your insurance. where you often have a surcharge. In other words, your pharmacist cannot legally tell you that there is a cheaper option for you. Most annoyingly, the Benefits Manager hides much of the difference .
This is not a small problem. “Researchers analyzing 9.5 million applications for prescriptions under Part D, reported in the March Journal of the American Medical Association, that the patient’s co-payment was higher than the price in cash for almost one out of four drugs, purchased in 2013,” – said Kaiser Health News … “For 12 of the 20 most commonly prescribed drugs, patients overpaid by more than 33 percent.” (On the other hand, the benefit manager claims that this is not that common and will depend on your pharmacist’s contract.)
President Donald Trump has proposed banning these items , at least for contractors of Medicare Part D (which manages prescriptions). And according to a June 1 report from the National Conference of State Legislators’ Prescription Drug Resource Center, more and more states are banning these rules, but they still exist:
Until then, there is one simple solution: ask your pharmacist if your prescription is worth less if you pay in cash the next time you walk in. Although they cannot give it to you, they can tell you if you ask, according to Kaiser Health News . “It’s a moral dilemma for the pharmacist: knowing what’s best for the patient, but not being able to help them and hoping they’ll ask you for a comparison,” Nick Newman, an Ohio pharmacist, told KHN. But ask, and you may find that paying in cash can lower your out-of-pocket expenses.
Another tip for Medicare members is that cash payments for a drug covered by your plan should be counted towards your personal expense if you apply to your insurer according to KHN. And it can save you tons of money.