When you see a doctor or get a medication, your insurance plan pays a portion of that cost, and you pay the rest. The part you pay is called a copay.
Your copays are determined by your insurance plan
The cost you pay for your medication can vary widely depending on what type of plan you have:
Many HMO plans have a fixed copay for all prescriptions. So your cost is the same, no matter how many you fill or how expensive the total cost.
Other plans charge what's known as coinsurance, which means you pay a percentage of the total medication cost, instead of a fixed amount. In this case, the pricier the med is, the higher your copay will be.
Some plans have a deductible, which means you pay full price for your medications up to a certain amount. After that, you usually pay a low copay.
Often, Medicare plans have what's known as a donut hole. That means you have a copay up to a certain dollar amount, then pay full price until you reach the yearly limit. After that, the donut hole closes and you go back to having a copay again.
Certain plans have tiered pricing, dependent on where you have your prescriptions filled. So if you use a preferred pharmacy, your copays will be lower than at an in-network pharmacy.
Some plans offer discounted copays if you fill 90-day supplies. Because we fill on a 30-day cycle, we're unable to offer this discount.
Because of the complexity of copays, it's hard for us to offer an accurate price quote without running a real insurance check for you. However, we are happy to offer a cost summary prior to sending your medications — simply give us a call at 855-745-5725 about two weeks before your order is scheduled to arrive.
High copay notifications
If we see an especially high price for one of your medications, we'll let you know. We'll also delay charging you for that particular prescription by 10 days. This gives you time to call your insurance and verify the price before paying it. Because we never want you to be without your medication, your order will ship as scheduled. Only the billing charge for the high priced item will be delayed.
We'll also let you know if we see a significant change in the price of your medication from one month to the next. If you have a deductible or a donut hole, you might be expecting this change, but we want to give you chance to take a look.