PDP and provider choices take chunks out of your clients’ out-of-pocket costs

Are you discussing with clients the importance of pharmacy choices and the context of their health needs, options, convenience and overall costs?

PDPs have preferred providers and lower-cost medications, yet many customers are still choosing more expensive pharmacies and medications. When it comes to using their health plan, clients make expensive mistakes about where they go for health care.

Why? Because they aren’t aware of their options.

Now more than ever, it is imperative that your clients understand where– and how– they can purchase their medications at the best price possible to reduce their out-of-pocket costs. You are their best resource to finding that information, and one they will rely on when exploring their options.

Whether leading educational events during enrollment or reviews, you must discuss the following points with your clients to be sure they understand the extent of their options:

  1. Where they go for their medications
  2. Analyze cost analysis (Medicare Plan Finder for seniors)
  3. How they can use their benefits
  4. Explain that it is not just pharmacy choice; it may be how they order, as most carriers have mail order options

If clients are made aware of their options, you can bet they’ll switch their purchasing methods to the one that will give them the best bang for their buck.

Along with discussing with clients the importance of being aware of their options in pharmacy choices, be sure to also offer reminders about the hierarchy of cost when using health insurance. The “where” and “when” makes a significant impact on cost to members and payors; Telemedicine may be “free” when included within a plan, whereas showing up at an emergency room could land you with a bill for many hundreds of dollars.

Medical treatment may be received via the following methods and become increasingly expensive if this level of care is not needed:

  1. Online and TeleMed services
  2. Primary Care Physician
  3. Urgent Care
  4. Emergency Room

While each is suitable for specific situations, it is important to emphasize to clients that each method varies significantly in cost. For example, if a client suspects they may have pink eye, they may want to utilize telehealth services versus paying a visit to the emergency room. Not only will an online service save them hundreds of dollars, it will also save them hours of their time.

Discussing how to use pharmacy and health insurance benefits for the best outcome and cost saving can make a huge difference to real expenditure for your clients. Whether your clients choose a high or low deductible health plan, the network, medication cost and focus on prevention, health and wellness will end up saving them bundles of money in the long run.