By Patricia Prewitt
My Personal Rx Adviser

About 13% of Americans are using a mail-order pharmacy such as ExpressScripts, CVS Caremark, or Optum Rx to fill prescriptions. Sometimes insurance companies and pharmacy benefits managers may require or incentivize the use of mail-order pharmacies for maintenance medications for chronic conditions. TriCare for military members and veterans programs heavily promote home mail delivery. People who live in more rural areas with limited access to pharmacies often benefit from these services. Mail-order delivery is thought to reduce healthcare costs.
What is meant by incentivize? Often this means that a 90-day prescription filled using a mail order pharmacy (three-month supply) may cost the customer less than the price of filling a 30-day (one month) prescription at a local pharmacy. For example, if your monthly (30-day supply) copay charge for a medication is $20, the prescription plan might offer a 90-supply via mail order at only $40 for 90 days (vs. $20 x 3 months=$60), saving you $20. That’s $80 over the course of a year.
It is important to note that some prescription insurance plans may also offer a reduced out-of-pocket cost for a 90-day (three-month) supply at a traditional retail pharmacy. This is often a smart choice for many generic medications.
Here are few of the benefits of using a mail-order Rx service:

  • Convenience. Prescriptions are delivered to your door, without requiring a trip to the pharmacy and long lines
    • Potential cost savings, based on your insurance plan rules
    • Easier compliance with a larger supply, making it less likely you will run out of your medication
    • Privacy of home delivery
    • Practical for chronic medications used routinely, at the same dose
    What are the downsides to using a mail-order service?
    Here are a few:
    • Shipping delays due to weather or slow postal delivery
    • Insurance restrictions that limit your choices
    • Risk of errors. Processing insurance changes and credit card errors can occur, and may take longer to fix
    • Specialty medications and controlled substances can be problematic
  • Changes to doses and stopping auto-renewing prescriptions may be difficult. Postal rules do not allow for the return of medications for credit
    • Savings coupons and manufacturer copay savings cards cannot be processed
    • It’s up to you to stop any prescriptions due a dosing change, discontinuation of the therapy or a death
    Non-traditional mail-order pharmacies: CostPlusDrugs by Mark Cuban based in Dallas uses a new direct-to-consumer pricing model that bypasses traditional prescription insurance processing. It can be worthwhile to compare your current out-of-pocket costs of current chronic medications at www.costplusdrugs.com. Amazon and other online entities are back in the market, competing for prescriptions. The non-traditional companies require an online account setup, a credit card, and often a new prescription or visit with an online prescriber. Compare these tasks, prices, and current costs before choosing to make a switch. There are tax considerations for health care costs if you itemize. Consult with a tax advisor and/or financial planner for specifics.

Content provided is for educational purposes only, and is not intended as a substitute for advice from a qualified medical professional. The opinions expressed within are those of the author.

About the Author: Patricia Prewitt is a local Massachusetts resident who spent more than 30 years in  the pharmaceutical industry. Tricia is a consumer education advocate, and loves helping people find ways to save money on their prescriptions. More information and free resources are available on her website at https://mypersonalrxadvisor.com/resources or call her at 508-507-8840. Favorite Quote: “Act as if what you do makes a difference. It does.” – William James