Medicare.gov pricing wrong - any recourse?

[russelltw]

Even if the price is correct, current plan is still least expensive for list of meds. Just found it odd that the carrier was so off on the rate, just glad it wasn't a bigger $ difference.

 

[XpressInsurance]

Even if the price is correct, current plan is still least expensive for list of meds. Just found it odd that the carrier was so off on the rate, just glad it wasn't a bigger $ difference.

The rates each plan quote has to do the PBM negotiated rate. The PBM negotiates with Big Pharma for a price for the plan. Here is the craziness, pharmacy sells medicine for $10 cash all day long, the PMB negotiates a deal to sell medication to plan for $20, but the pharmacy will actually only get $12 then the PBM gets rebated from Big Pharma for the negotiating the rates.

GoodRx knows what pharmacy pays for it & willing to sell it for & directs you to that pharmacy. I have Sam's Club membership, I buy omeprazole for my wife at $10 outside my plan vs. my health plan has negotiated a price of $20 with Walgreens. Many people could save money buying meds outside plans.