Cost Sharing Highlights » Retail Coinsurance Thursday, July 29, 2010
 

 

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Retail Coinsurance

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A coinsurance cost-share amount is a percentage of the total prescription cost. Although implementing coinsurance requires a lot of clear and frequent member communication, the approach buffers the employer from prescription drug cost inflation. As prescription costs increase, the member pays more. In many cases, employers may add a dollar minimum and/or a dollar maximum. For example, a preferred brand prescription cost share might be 25% of the total prescription cost. Or, it might be 25% of the cost of the drug with a $3 minimum amount to be paid for prescription. A different employer might not set a minimum but set a maximum so its member would pay 25% of the cost of the drug with a maximum of $150 to be paid.

 
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