Posts Tagged ‘PBM’

A Common Myth: Prescription Insurance Co-pays are always the Cheapest Option

Sunday, November 29th, 2009

As the debate over healthcare in the United States escalates, it is worth some time to take a look at your own medical benefits (if applicable) and analyze what it is your benefits offer you.  Too often,  people (both insured and uninsured) are under the impression that filling their prescription medicines will cost huge amounts of money, and don’t do so as a result.  In many cases, this is false, and may actually end up costing you more down the road.
 
Today’s prescription insurance structure is a complicated maze of different copays/coinsurance, certain drugs not being covered because they are not “preferred,” and less coverage for more money.  Meanwhile, pharmacy insurance companies (othewise known as PBM’s or Pharmacy Benefit Managers) are making more money than ever by dictating what medication your doctor can prescribe you based on what medications they can get the best deal on from manufacturers.  This coupled with the fact that using your insurance can actually cost you more than paying a “cash” price, makes it all seem like a wasteful mess.
 
So what can you do to decrease some of these costs and the confusion?  In conjunction with the normal letters to your local and state representatives and human resource personnel, try avoiding using that insurance all together when possible.  By avoiding using the insurance when lower cost alternatives are available, you decrease confusion, increase compliance, and save money in the long run.  By utilizing our prescription medication list with your doctor, low cost alternatives for a large majority of medicines can be found for pennies a day.  Take control of your healthcare costs now!  You’ll feel better, save money, and live a better life!