West Virginia
We’re the first state in the U.S. to require insurance companies and pharmacy middlemen to share savings rebates they receive from pharmaceutical companies with patients at the pharmacy counter.
West Virginia
We’re the first state in the U.S. to require insurance companies and pharmacy middlemen to share savings rebates they receive from pharmaceutical companies with patients at the pharmacy counter.
About Share the Savings
Many patients with commercial health insurance are required to share in the cost of their
prescription medicines. The cost to patients is often much higher than the cost to their insurance company – for the same medicine on the same prescription. Health insurance companies and PBMs negotiate significant rebates and discounts on the cost of the medicine and don’t always share these savings with patients. The West Virginia law requires them to do so now.
Who Qualifies?
West Virginians on commercial health insurance (employer-provided) who take brand named drugs can benefit from this new law. Usually, the higher the cost of the medicine, the larger the savings. But, typically, patients should see a 35% to 40% reduction on the cost of their qualifying brand medicines. This program can help lower what patients pay out-of-pocket at the pharmacy counter by hundreds of dollars each year.
When should I begin to see the savings?
The legislation went into effect on July 1, 2022. Some people may have already begun to see savings, but typically the larger savings occur during the deductible period, which begins after an insurance plan’s annual enrollment.
What if I don’t see any cost reduction?
Check with your pharmacist to see if you qualify. Those seeing the savings will be on commercial insurance (employer-provided) for brand named medicines. Generic medicines won’t qualify. You will typically see the larger savings during your deductible period.
About Share the Savings
Many patients with commercial health insurance are required to share in the cost of their prescription medicines. The cost to patients is often much higher than the cost to their insurance company – for the same medicine on the same prescription. Health insurance companies and PBMs negotiate significant rebates and discounts on the cost of the medicine and don’t always share these savings with patients. The West Virginia law requires them to do so now.
Who Qualifies?
West Virginians on commercial health insurance (employer-provided) who take brand named drugs can benefit from this new law. Usually, the higher the cost of the medicine, the larger the savings. But, typically, patients should see a 35% to 40% reduction on the cost of their qualifying brand medicines. This program can help lower what patients pay out-of-pocket at the pharmacy counter by hundreds of dollars each year.
When should I begin to see the savings?
The legislation went into effect on July 1, 2022. Some people may have already begun to see savings, but typically the larger savings occur during the deductible period, which begins after an insurance plan’s annual enrollment.
What if I don’t see any cost reduction?
Check with your pharmacist to see if you qualify. Those seeing the savings will be on commercial insurance (employer-provided) for brand named medicines. Generic medicines won’t qualify. You will typically see the larger savings during your deductible period.