Can a prescription benefits provider control where you purchase your medications?

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Can a prescription benefits provider control where you purchase your medications?

My prescriptions benefits provider has just issued a mandatory additional $25 fee, along with my regular coinsurance for any long term medication after the third purchase. This, if I utilize a local pharmacy rather than purchasing 3 month supplies from the benefits provider directly online. Can they do this? Doesn’t this create some type of monopoly through insurance?

Asked on March 30, 2012 under Insurance Law, California

Answers:

FreeAdvice Contributing Attorney / FreeAdvice Contributing Attorney

Answered 9 years ago | Contributor

Unfortunately, your prescription benefits provider's edict with respect to the medications that you are writing about controls in that such a provider is part of your insurance policy as an approved provider. I suggest that if you have an issue with this edict you need to consult with your health care representative and voice your concerns.


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