[{"@context":"https:\/\/schema.org\/","@type":"BlogPosting","@id":"https:\/\/www.rizklaw.com\/blog\/when-paying-cash-is-cheaper-than-using-health-insurance\/#BlogPosting","mainEntityOfPage":"https:\/\/www.rizklaw.com\/blog\/when-paying-cash-is-cheaper-than-using-health-insurance\/","headline":"When Paying Cash is Cheaper than Using Health Insurance","name":"When Paying Cash is Cheaper than Using Health Insurance","description":"A yearly investigation by Minneapolis station KARE11, followed by two recently filed class-action lawsuits, found\u00a0that pharmacists must sign so-called \u201cgag\u201d clauses preventing them from disclosing lower prices than what patients with insurance were paying for medications. In most cases, an insurance co-pay for a medication was twice as expensive as for just paying cash for...","datePublished":"2016-11-12","dateModified":"2024-05-22","author":{"@type":"Person","@id":"https:\/\/www.rizklaw.com\/blog\/author\/rizklaw\/#Person","name":"Rizk Law","url":"https:\/\/www.rizklaw.com\/blog\/author\/rizklaw\/","identifier":9,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/10e23ce5e6c4dadb4589cd8edf2c3f59ac356a6e876c3656917777913d9c3bc1?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/10e23ce5e6c4dadb4589cd8edf2c3f59ac356a6e876c3656917777913d9c3bc1?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"Rizk Law","logo":{"@type":"ImageObject","@id":"https:\/\/www.rizklaw.com\/wp-content\/uploads\/2024\/03\/rizk-law-logo-footer.jpg","url":"https:\/\/www.rizklaw.com\/wp-content\/uploads\/2024\/03\/rizk-law-logo-footer.jpg","width":278,"height":65}},"image":{"@type":"ImageObject","@id":"https:\/\/www.rizklaw.com\/wp-content\/uploads\/2024\/03\/Richard-Rizk-headshot.jpg","url":"https:\/\/www.rizklaw.com\/wp-content\/uploads\/2024\/03\/Richard-Rizk-headshot.jpg","width":383,"height":427},"url":"https:\/\/www.rizklaw.com\/blog\/when-paying-cash-is-cheaper-than-using-health-insurance\/","about":["Medical Issues"],"wordCount":308,"articleBody":"A yearly investigation by Minneapolis station KARE11, followed by two recently filed class-action lawsuits, found\u00a0that pharmacists must sign so-called \u201cgag\u201d clauses preventing them from disclosing lower prices than what patients with insurance were paying for medications. In most cases, an insurance co-pay for a medication was twice as expensive as for just paying cash for the same medicine.Why Co-Pay More Expensive than Paying Cash?Pharmacy Benefit Managers (PBMs), which serve as the middleman, set the price you pay the pharmacy for medications. In many cases, the price they set for your co-pay is twice the cash price. \u201cGag clauses\u201d in the contracts pharmacists sign with PBMs prevent them from telling you this.What Happens to the Extra Amount You Pay?Instead of going to the pharmacy, as much as 80 percent of your more expensive co-pay is pocketed by Pharmacy Benefit Managers and insurance companies. UnitedHealth Group, which gets much of its revenue from its Pharmacy Benefit Management division, frequently uses the so-called \u201cclawback tactic\u201d to reap profits from sales of pharmaceuticals.UnitedHealth Group Named in Two Class-Action SuitsIn October 2016,\u00a0two class-action lawsuits\u00a0were filed accusing UnitedHealth Group of a \u201cscheme to defraud\u201d customers in connection with prescription copay pricing.The lawsuits claim that UnitedHealth Group and its related companies used \u201cgag clauses\u201d to try to keep its so-called \u201cclawback scheme\u201d secret.You Can Shop for Lowest Prices on MedicineThere is one drawback to paying cash for your prescriptions. The money you pay does not apply toward your deductible. If you want to pay cash, consumer advocates recommend shopping around. To search for the least expensive price for your prescriptions see\u00a0Consumer Reports article with tips about finding the best prescription drug prices. You can also check prescription drug prices and find discount coupons at pharmacies in your area through\u00a0GoodRX.com\u00a0and\u00a0Lowestmed.com."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Blog","item":"https:\/\/www.rizklaw.com\/blog\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"When Paying Cash is Cheaper than Using Health Insurance","item":"https:\/\/www.rizklaw.com\/blog\/when-paying-cash-is-cheaper-than-using-health-insurance\/#breadcrumbitem"}]}]