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When paying cash for prescriptions beats using insurance

By Theo Thimou

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. PBS News Hour recently ran a piece that spotlighted the story of one woman and her husband who were going on a trip and needed to stockpile a 90-day supply of telmisartan. The woman was prescribed the drug to control her blood pressure after a mini-stroke about two years ago. The husband tried to order the generic drug through Express Scripts, the pharmacy benefits manager (PBM) that also provided a mail-order service for their insurer Anthem. But here’s the rub: The couple had paid $285 for a 90-day supply of the drug about a month earlier. Because 90 days hadn’t passed, Express Scripts refused to sell an additional 90-day supply to the couple.



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