How to avoid prescription drug price surprises

More people these days are shocked to find out that their insurance dropped their pharmacy or doesn’t cover the drug the doctor prescribed.

Most health plans, including Medicare Part D, encourage members to use a specific network of pharmacies. If you don’t, you might have to pay more for medicines.

Another growing problem is medication that’s no longer covered by your insurance.

“The list of drugs that insurers cover are actually decided by middleman companies called pharmacy benefit manager, that when they negotiate deal with drug companies, may change or even exclude certain medicines from the coverage,” said Lisa Gill of Consumer Reports.

But some drug exclusions can actually save consumers money, like when low-cost, generic versions of an expensive name brand drug becomes available.

“Your first step is to check with your pharmacy and make sure that all of your information has been entered correctly into their system. There may be some glitch that is stopping the insurance company from covering the drug properly,” Gill said.

You can also ask the pharmacist what the lowest cash price they can offer.

Another tip -- many plans require you fill certain prescriptions through mail order pharmacies. So, if your drug suddenly jumped in price or stopped being covered, check to see if you’d be better off getting them through mail order.