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Did you know people who have health insurance don’t have to use their insurance when buying prescriptions at a pharmacy? They can ask the pharmacist to check if the medicine would be cheaper without running it through insurance.
Due to contracts with entities called Pharmacy Benefit Managers (PBMs), pharmacies in some states may be prohibited from telling patients up front that their cost would be less without using insurance. But more states are passing laws against these so-called gag rules. So be sure to ask your pharmacist about the price options if you have insurance and haven’t met your deductible yet.
Note that if you don’t use your insurance when buying a covered drug at an in-network pharmacy, save the receipt, since you can often file a claim to your insurance later if you want the cost to be counted towards your deductible and out-of-pocket maximum. Also, you can still use your Health Savings Account or Flexible Spending Account for prescriptions you didn’t run through your insurance, as long as your doctor prescribed them for a legitimate medical purpose.
Stay tuned for more pharmacy tips in next month’s newsletter!
(Source: Chapter 10 of our book Decoding Health Insurance and the Alternatives: Options, Issues, and Tips for Saving Money)
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