CBS DFW, a local television station covering the Dallas-Fort Worth (Texas) metro area, has documented yet another example of PBM clawback practices that are negatively impacting community pharmacy patients. One local pharmacist says he see examples on a daily basis of customers with insurance being charged a higher price for a prescription drug than those with no insurance at all, and he can’t recommend lower-priced alternatives because of contractual confidentially clauses that would prevent him from telling customers their copay is more than the drug price. In one example, a customer with insurance purchased a common generic drug. His copay for that drug was $125, but had the customer paid with no insurance the cost would have been just $55—a difference of $65. The station did point out that if patients bring up the question unprompted about how much a prescription would cost if they didn’t use their insurance, the pharmacist can tell them.
If you have Medicare part D and by checking the price of your prescription on the above two websites and ask the pharmacist before you get it filled the cash price and use your prescription insurance card.. Could both save you money and keep you from going into the “donut hole” and save you more money.
Some PBM (Prescription Benefit Managers) apparently are charging pts a SURCHARGE for using their prescription insurance. Just like auto insurers raise your premium if you have a accident and have to use your insurance.
They have “gagged” the Pharmacists from telling you about this form of ROBBERY.. unless you ask…
By checking your cash prescription prices with the above two websites.. you can beat the PBM at their own game 🙂
Filed under: General Problems
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