CONSUMER ALERT: CONSUMERS URGED TO STUDY PHARMACY OPTIONS

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October 22, 2014

LITTLE ROCK – As consumers consider their insurance options and health-care needs for the upcoming year, some may be surprised to learn that insurance companies may utilize mail-order pharmacies to fill beneficiaries’ prescriptions.

Insurance companies often use Pharmacy Benefit Managers, or PBMs, to process pharmacy benefits under a consumer’s health insurance plans. Some of those PBMs automatically enroll consumers into mail-order prescription drug programs. These mail-order programs purport to save the consumer money on prescriptions and promise the convenience of at-home delivery at in-network prices.

While many consumers may find mail-order pharmacies to be beneficial, others may want to retain the option to buy their prescription drugs at a local pharmacy. Therefore, Attorney General Dustin McDaniel issued this consumer alert today to encourage Arkansans to read all correspondence from their insurance providers and make sure they know their options.

“The Health Care Bureau of my Consumer Protection Division has received several calls with questions about mail-order prescription drug programs in which beneficiaries are automatically enrolled in the plans,” McDaniel said. “We ask consumers to read the mailings and understand their choices. It’s almost always possible for consumers to opt out of these programs if they so choose, but they must proactively do so, and they must do so in a timely manner.”

McDaniel said any mailings from insurance providers about mail-order pharmacy plans will contain information about how consumers can choose to continue to obtain medications from local pharmacies. Most likely, consumers would be required to call the insurance company or fill out a specific form in order to opt out.

In considering their choices regarding opting out, consumers should determine whether there are cost advantages to the mail-order prescription drug plan and whether they would prefer to remain with a local pharmacist because of an already-established relationship. 

McDaniel offered the following advice on this issue:

  • Consumers should ask insurance companies about the benefits and costs of a mail-order pharmacy, and what the cost-savings may be on specific prescriptions.
  • Consumers who opt out of a mail-order program should remember that they may be required every year to renew their “opt out” options.
  • Consumers who prefer to use local pharmacies need to confirm with their health insurance companies that prescriptions will be covered at either in-network price levels or at levels that would be acceptable to the consumer.

For more information about this or other consumer matters, visit the Attorney General’s Consumer Protection Division website, www.GotYourBackArkansas.org, or call the Consumer Protection Division hotline, (800) 482-8982.


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