Transparent Claims and Pass-through Pricing
We use a pass-through pricing model that has no hidden fees or marked-up rates. This means our competitive, contracted rates with participating pharmacies are the same rates you will pay for prescription drugs. All expenses are disclosed, and we’ll share our pricing information with you. We even use a single Maximum Allowable Cost (MAC) list across all channels (retail and mail).
We pass all incentives and rebates directly to you. You get back 80% of all manufacturer incentives. While others might advertise a higher percentage, our “complete rebate” means you get everything we get:
- Administrative fees
- Price protection
- Service contract payments
- Disease management payments
Questions? Just Ask
Here are 3 questions you should ask before choosing a PBM:
- Is the amount reimbursed to all providers for each brand and generic claim the same amount invoiced to you?
- Does your PBM pass through all manufacturer rebates and financial benefits?
- How many MAC lists does your PBM use and can you review the price list(s)?
We think you’ll like our answers.
We can show you examples of the cost savings other companies have seen with SelectHealth Prescriptions:
- One client, with 6,200 members, saved $450,000 (a 12 % savings) over a traditional PBM.1
- Another, with over 25,000 members witnessed a 15 % savings over their previous PBM.2
1. Traditional PBM rates were calculated using $4.50 per Rx for both brand and generic 30-day prescriptions, and $11.00 per Rx for brand name and generic 90-day prescriptions. Actual client savings may vary depending on plan demographics and programs implemented.
2. Based on an internal review of costs/claims made under a previous PBM versus SelectHealth.