Insurance company is forcing me to use their pharmacy, is there anything I can do?

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Insurance company is forcing me to use their pharmacy, is there anything I can do?

I have BCBL Health Insurance and Caremark takes care of our perscription meds. I get my meds through Walmart and the Caremark has sent me a letter requiring me to purchase a 3 month supply of my medication from CVS or from their mail order company. If I purchase them anywhere else, they will not pay. I used to get my meds from CVS and had problems with pill shortages and perscription mix ups. What are my rights and what can I do?

Asked on May 23, 2009 under Insurance Law, North Carolina

Answers:

L.M., Member, California Bar / FreeAdvice Contributing Attorney

Answered 11 years ago | Contributor

Unfortunately, these days our health insurers are calling the shots about where we can and cannot get our health care and fill our prescriptions.  Most insurers have their list of preferred providers and if we stray from the list, either they pay a lot less or nothing at all.  I would check and see if they will pay something for your prescriptions if you have it filled "out of network".  If not, I'm afraid you're stuck with CVS (with whom they likely have a contract for lesser costs) or mail order.  Usually mail order is the cheapest way to go.


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