Your Medication Coverage May Be At Risk

Unbeknownst to members, insurance companies often change which prescriptions are covered and which are not. This is not always shared with the insured members prior to the changes. In addition to being expensive and inconvenient, these modifications may make the medicine that you depend on virtually inaccessible and have real consequences for your quality of life.

Although you’re not always made known to these changes directly from your insurance provider, you do have the power to get informed and take action to make sure that the medication that you depend on, including your compounds, remain accessible to you.

Here’s what you can do:

Go to and get informed about recent changes to certain insurance and benefit plans.

Take action: Learn how to talk to your HR or benefits manager to keep your coverage and get other tools designed to protect your access to compounds.

Click here to receive email alerts about new developments.

Compounding is the Art and Science of Creating Personalized Medications

Pharmacy compounding is the art and science of preparing personalized medications for patients. Compounded medications are “made from scratch” – individual ingredients are mixed together in the exact strength and dosage form required by the patient. This method allows the compounding pharmacist to work with the patient and the prescriber to customize a medication to meet the patient’s specific needs.

A Brief History of Compounding

In the past, nearly all prescriptions were compounded. With the advent of mass drug manufacturing in the 1950s and 1960s, compounding rapidly declined. The pharmacist’s role as a tailor of medications quickly changed to that of a dispenser of manufactured dosage forms, and most pharmacists no longer were trained to compound medications. However, the “one-size-fits-all” nature of many mass-produced medications meant that some patients’ needs were not being met.

Will My Insurance Company Cover My Compounds?

Because compounded medications are exempt by law from having the National Drug Code ID numbers that manufactured products carry, some insurance companies will not directly reimburse the compounding pharmacy. However, almost every insurance plan allows for the patient to be reimbursed by sending in claims forms. While you may be paying a pharmacy directly for a compounded prescription, most insurance plans should cover the final cost.

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