An epinephrine auto-injector (known by the brand name ”Epipen”) may have different billable rates and are set up based on the formulary which determines what tier they fall. Below is just an example and not representative of actual dollar amounts.
Retail price: $650 (the price you would pay without pharmacy coverage)
Company A’s Part D plan: $376
Company B’s Part D plan: $298
Company C’s Part D plan: $350
Your responsibility may vary based on the insurance carrier you go with for your prescription coverage.
Company A may require a 10% coinsurance ($37.60), Company B may require a flat $50 copay, and Company C may have a 20% coinsurance ($70). Depending on premiums, Company A may be the best choice; however, the more cost sharing you are willing to be responsible for, the lower the premiums will be. In this case, Company C may be the best choice when you look at cost sharing AND premium payout combined.