A bitter pill to swallow

If you're in the Blue Cross and Blue Shield federal employee health plan,

you probably think that you would pay the same price for prescription drugs

at any local pharmacy. Well, guess what? That's not true: It pays to shop

around.

I recently filled a prescription at my local pharmacy for a medication

that an Internet pharmacy sells for about 6 cents a pill. I figured I'd

probably pay that amount — or less. After all, I'd be getting the rate negotiated

between my health plan and the pharmacy, and certainly that would be equal

to or less than what an Internet pharmacy was charging everyone.

Was I ever surprised when the local pharmacy price came to 15 cents

a pill! Because my insurance covered 75 percent of that, I wound up paying

3.75 cents a pill. But even though the online pharmacy selling the medication

for 6 cents a pill was not part of my health plan, I would have been reimbursed

for 55 percent of the cost and paid less out of pocket — about 2.7 cents

per pill.

When I called the plan's local pharmacy service for an explanation on

the price discrepancy, I was told that the plan pays local pharmacies a

percentage of what the drugstore charges people who don't have insurance.

The discount is probably standard for every medication the local pharmacy

sells.

Of course, not every pharmacy is a participating pharmacy. Some charge

so much that the plan just can't negotiate an acceptable discount. But most

pharmacies in the Washington, D.C., area (where I live) participate in the

Blue Cross plan.

However, their basic prices for prescription drugs aren't identical.

Some charge more than others do to begin with, which affects the final price.

So the amount you pay for a prescription drug won't be the same in every

pharmacy that participates in your plan.

Here's the best part: The representative from my health plan told me

about a major online pharmacy that is a participating provider. Which one,

I asked? Drugstore.com, I was told. That's a well-kept secret, I said, to

which I didn't receive a reply. When I went to that Web site, I found my

medication selling for 6 cents a pill. That means it would cost me 1.5 cents

a pill at drugstore.com (25 percent of 6 cents). And no charge for shipping!

Of course, I was buying a relatively inexpensive medication. For anything

expensive and long-term, you'd probably want to use the mail-order pharmacy

and get a 90-day supply for $12 or $20, depending on whether you're ordering

a generic or brand-name drug. And for medications you need in a hurry, you'll

likely want to use your local pharmacy.

But if you have the time and the choice of more than one pharmacy, it

definitely pays to shop around.

Zall is a retired federal employee who since 1987 has written the Bureaucratus

column for Federal Computer Week. He can be reached at miltzall@starpower.net.