Dr. Holly Phillips shared tips for consumers when their prescription drugs have been dropped from their insurance.
Phillips’ five tips:
1. Make sure the pharmacy has your up-to-date insurance information.
Sometimes claims are denied simply because the drugstore computer system has old insurance information for you. Also confirm that another pharmacy doesn’t have a duplicate prescription for you, as can happen when you’re transferring prescriptions from one pharmacy to another. Either situation could lead to claim denial.
2. Confirm that the drugstore is in your insurer’s network.
Confirm that the drugstore is in your insurer’s network. Most health plans require you to use a specific network of pharmacies to fill prescriptions. If you go outside that network, your claim could be denied and your insurer may require you to pay more, or all, of the cost.
3. Is there a mail order requirement?
See whether you must use mail order. About 25% of plans require you to fill certain prescriptions through mail-order pharmacies, so if your drug suddenly went up in price or stopped being covered, check to see whether coverage would be better through mail order.
4. Check to see if you can get your drug at a better price without your insurance.
Check to see if you can get your drug at a better price without your insurance. Just because you have insurance doesn’t mean you need to use it. Free-to-use prescription coupon platforms like RxSaver by RetailMeNot™ can help you save up to 85% on your prescriptions. These platforms don’t work with insurance, so they’re a great option whether or not your drug is covered—and especially if it has been dropped
5. Ask for a cash price.