28/07/2024
Pharmacies frequently forget to bill patient’s health insurance. It should be illegal for them to do so, but it isn’t.
I’ve had patients pay >$2000 on one med that should have been paid by their insurance companies. Unfortunately by the time i find out about it, what’s done is done.
This came up today because CVS on fourth street failed to bill our insurance for a med and tried to get me to pay $170 for it. Only when I questioned whether they had billed insurance did they admit that they had not. Had I not been aware, I would have paid $160 extra for the prescription.
Please, people if a pharmacy ever tells you that a medication is going to cost you more than your copay, there are only three reasons for this 1. They forgot to bill your insurance 2. Your medication needs a prior authorization from your insurance company - ask the pharmacy if this is the case. If it is, contact the prescriber unless it is an emergency to get started on the med. 3. You have a deductible on your drug plan and must pay the amount of the deductible before you get to pay just your copay amount. Always ask before paying!
Hope this saves someone some $ sometime!
