Ohioans who go to the pharmacy to pick up prescriptions sometimes pay more out of pocket with their insurance card than they would have if they didn’t have coverage. But state regulators are doing something to try to ensure Ohioans pay the least possible.
The Ohio Department of Insurance’s Jillian Froment says sometimes pharmacists don’t disclose potential cost savings because of what’s often called a “gag order.”
“Contracts they have with pharmacy benefit managers prevent them from letting a consumer know that there is a cash option available that would be less expensive than using their insurance card to cover their pharmacy benefit.”
Froment says state regulators are now ordering insurers and pharmacy benefit managers, who act as middlemen in the process, to tell Ohioans if they could save money by opting for a lower priced drug and paying cash. Some Ohio lawmakers are also pushing for a bill to allow the state auditor to review contracts between pharmacies and benefit managers.