Insurance Claim Injustice: Prescription “Clawbacks”

Personal injury victims, chronically ill patients, and all of us from one time or another need prescription medicine. But we might be getting ripped off.

Whistleblower pharmacists estimate that 20-25% of patients with some health insurance pay more for prescription copayments than the cash price of the medication. Health insurers overcharge their customers and pocket the profits – a “clawback” process requires pharmacies to return much of the copayment to the insurer. They impose “gag clauses” on pharmacists to prevent them from alerting consumers.

Insurance Prescription Claim Ripoff

Which insurers are the worst offenders, and whether all or only some insurers engage in the “clawback” scheme, is unclear.

But “clawbacks” appear to be happening all over the country. And aside from a class action lawsuit here and there, which may eventually cost the insurers some money but certainly won’t return every customers’ money in full, no one is doing anything about the problem.



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