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Capping Illusions: Why limits on out-of-pocket drug spend don’t work.

While a proposed cap on out-of-pocket drug spend seems to be the common response to the current drug pricing conundrum, in reality there are significant  drawbacks. On the surface, capping out of pocket drug costs seems like a great idea.  Patients would no longer have to worry about paying exorbitant prices for their medications. However, it is important to think about …

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Co-Insurance for Medications: A New Trend for Consumers

As we brace for healthcare changes in the coming years, one particular trend that will negatively impact consumer out-of-pocket costs is the use of co-insurance (instead of a co-pay) for expensive specialty medications. Many consumers are accustomed to paying flat insurance co-pay amounts for various tiers of medications, with the highest tier generally capped at a co-pay between $50 and …

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Understanding your Insurance Policy’s Formulary

Just because your medications are covered today doesn’t mean that they will be covered next month. Roughly 10% of those purchasing medications will find that their insurance company no longer covers the drug they take. Formularies change very often so let’s discuss drug formularies, how they work and what you can do to reduce your healthcare costs.    A formulary …