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Why a patient paid a $285 copay for a $40 drug

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Why a patient paid a $285 copay for a $40 drug

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By Theo Thimou | August 22, 2018 3:01 pm

It’s usually taken on faith by health care consumers that you can save big money on prescriptions when using your insurance company’s mail-order pharmacy program. But there are some instances where it’s a heck of a lot of cheaper to pay cash for a medication at the pharmacy counter, rather than to order it through your insurer’s pharmacy benefits manager program.

Two years ago Gretchen Liu, 78, had a transient ischemic attack — which experts sometimes call a “mini stroke” — while on a trip to China. After she recovered and returned home to San Francisco, her doctor prescribed a generic medication called telmisartan to help manage her blood pressure. Liu and her husband Z. Ming Ma, a retired physicist, are insured through an Anthem Medicare plan. Ma ordered the telmisartan through Express Scripts, the company that manages pharmacy benefits for Anthem and also provides a mail-order service. The copay for a 90-day supply was $285, which seemed high to Ma. (READ FULL STORY on PBS NEWS HOUR …)

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SOURCE: https://clark.com/health-health-care/prescriptions-paying-cash-vs-insurance/?utm_source=Clark+Newsletter+List&utm_campaign=b3cc68e123-Clark_Daily_Newsletter&utm_medium=email&utm_term=0_afa92deb83-b3cc68e123-72358257

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