A Tricky Way in Which Your Coverage for Essential Medications May be Denied
We all know that the American healthcare system is a complex one with a lot of bureaucracy. One such complexity involves how prescription medications are handled. Pharmacy Benefit Managers (PBMs) process prescriptions for insurance companies and corporations, using their size to negotiate low prices with drug makers and pharmacies. Essentially, they act as the “middlemen” between the payer and everyone else in the healthcare system.
Recently, a PBM named Express Scripts, adopted a policy to block coverage of approximately 1,000 ingredients used in compounding; they made this decision for no other reason than to cut their expenses. They actually went