By now, you’ve likely heard about various low-cost, independent prescription drug programs i.e. Amazon Pharmacy and Cost Plus Drugs.
These programs focus on providing lower cost medications outside of the traditional insurance systems.
But what happens when you buy medications here instead of through your major medical plan? We are here to help fill you in understanding the prescription drug programs.
The first thing to consider is that these pharmacies may be outside your current insurer’s network. Is it a problem to use out-of-network pharmacies? The answer is … it depends.
Dollars spent out of network are not applied toward your annual in-network deductible or out-of-pocket maximum.
On the surface, this sounds like a bad thing, but it may not always negatively impact you.
If you believe that you are unlikely to satisfy your out-of-pocket maximum and the medications are cheaper out of network, then you could save money in the long run.
If you have a costly, major procedure planned or have a chronic condition requiring frequent medical care, you are more likely to meet your deductible.
Having out-of-network expenses could end up costing you more money. Even if a medication that’s in network is more costly, prescription drug claims incurred will help you reach your deductible (and out-of-pocket maximum) faster. This will help you satisfy your deductible and ultimately reduce overall expenditures.
What Else Should We Be Considering?
Another important factor to consider is that the service may charge a membership fee in addition to medication costs.
In addition, medications may be available only for the member, not their dependents.
The bottom line is that you need to assess your unique situation. It is unknown how you may incur medical expenses throughout the year.
With the help of your Benefits Department and/or your broker, you can review your available options and make the most educated decision possible.
Learn more at https://www.eesipeo.com/employee-benefits/