PostHeaderIcon Insurance company found new way to add administrative burden and increase member cost

Creating new programs to administer more and pay less is an ever growing trend with insurance companies. United Healthcare new specialty medication management program is just that; more hoops to jump for less.

Industry insiders long known that the federal Medicare program is a leader in the creation of more administration and less payment.  Blue Cross and Blue Shield usually follow closely, and then the rest of the pack (insurance companies in general).

Now United Healthcare seems to be taking the leading role of creating an additional program without benefits to its members.  The Specialty Pharmacy Program is designated to put more stops in prescription utilization for high cost drugs. New and renewal members will be forced to obtain certain medications from a participating specialty pharmacy to receive in network coverage. Furthermore this policy eliminates the previous 90 day supply benefits, both as a discount and convenience. Members will be forced to renew prescriptions each month and pay the 30 day co pays.

Typical of insurance policies, coverage by out of network pharmacy is not clearly defined. No one can tell until they visit a local pharmacy.

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