There are 3 ways to verify if you have overpaid for your medication:
1. Call your pharmacy & ask for the retail price of your medication
2. Enter the name of your medication & your zip code at LowestMed.com
3. or call (800) 776-6044 & we will research the retail price of your medication free of charge.
RX Rip-off: Major Health Care Companies Illegally Profit from Your Prescription
Are your medications cheaper without insurance?
Keller Rohrback L.L.P. is investigating the following health care companies for forcing patients to overpay for many commonly-used prescriptions:
- Humana—with prescription services through Humana Pharmacy Solutions, Inc.
- Cigna—with prescription services through OptumRx, Catamaran, and Argus Health Systems, Inc.
- UnitedHealthcare—with prescription services through OptumRx
You may be overpaying if you pay a copay, coinsurance, and even the full price of the drug. Affected health insurance plans include employer-sponsored plans, ACA exchange plans, and Medicare plans.
When you fill your prescriptions, the stated price is determined by your insurance policy, not your pharmacy. For example, if a drug retails for $5.00 at Walgreens (the price you would pay without insurance), you may be required to pay $20.00 – four times more – because $20.00 is the stated price in your insurance policy. The chart below illustrates a few examples. Click here to see a more complete list.
This billing practice is known as a “clawback” and you may have no idea it’s happening to you because your pharmacist isn’t allowed to tell you under a gag order in place that restricts pharmacists from telling patients they are being overcharged. These clawback monies are a contributing factor to the high prices of health care in our country and also contribute to the yearly compensations the CEOs of these companies receive. The CEO of United Healthcare alone received $14.5 million in 2015, meaning the CEO made $39,775 a day.
Several pharmacists have anonymously turned over documents that show how clawbacks work. An unnamed pharmacist provided the claim information below to Fox 8 in New Orleans.It shows the retail cost of Sprintec is $10.04 but OptumRx instructed the pharmacy to collect $50 from the patient. UnitedHealthcare and OptumRx contributed nothing for the drug and then collected the additional $38.35 clawback from the pharmacy, almost four times the retail cost of Sprintec.
UnitedHealthcare, Cigna, and Humana are taking advantage of people when they need help the most. The prescriptions they overcharge for treat illnesses that affect everyone, whether the patient is your child, your parent, or yourself. These illnesses include depression, A.D.H.D., epilepsy, breast cancer, diabetes, heart disease, arthritis and Parkinson’s to name a few.
Contact us to find out if you’ve been overcharged. We can research the local retail cost of your prescriptions if you provide your zip code, the name and dosage of your prescriptions and the amount of your copay. Be assured that any information you share will be remain confidential.
You are welcome to call us toll free at (800) 776-6044, email , or fill out the contact form below.
The Great Big Prescription Drug Clawback – 05/20/2016