Uncovering the Costs of Prescription Medication Overpayment & How to Fight Back

The rising cost of prescription medications burdens many Americans, but did you know that you might be paying more than you should—even for medicines covered by insurance? 

Overpayment of prescription drugs is a growing issue that impacts millions. You may be compensated if you've paid more than expected for your medications. Our legal team can help determine your qualifications and guide you through the following steps.

Co-Insurance

If you paid co-insurance for medication through your health plan, you may have overpaid, based on the true cost of the drug.

Employer Health Insurance

Your employer-sponsored health plan may be overpaying significantly for prescription drugs.

The Hidden Costs of Prescription Overpayment

For many, prescription medication overpayment goes unnoticed. But paying too much for your medications—especially when you have health insurance—can strain your finances and put undue stress on your well-being. Overpayment often occurs because insurance companies and PBMs apply complex pricing structures that are difficult for consumers to understand. A 2021 study by the Journal of the American Medical Association found that 23% of all prescription drug claims resulted in overpayment, with the average overpayment being $7.69 per claim. Over time, these small overcharges can add up to hundreds, even thousands, of dollars annually.

Why Are Prescription Medication Prices So High?

Prescription drug prices in the U.S. are notoriously higher than in other countries, and even with insurance, consumers can face high out-of-pocket costs. According to the Centers for Medicare & Medicaid Services (CMS), Americans spent nearly $370 billion on prescription drugs in 2021, which continues to climb yearly. But why are these prices so high?

• Pharmacy Benefit Managers (PBMs): These intermediaries between insurance companies, pharmacies, and drug manufacturers often negotiate rebates not passed on to consumers.
• Lack of Transparency: Insurance companies sometimes impose complex pricing models that make it hard for consumers to understand what they should pay.

A healthcare pricing expert, Dr. Thomas Gaither reveals, "The complexity of drug pricing in the U.S. means that consumers are often unaware of overpayment for their medications, and it's only through proactive investigation that they can uncover these discrepancies.”

Are You Eligible for Compensation?

You might be eligible for compensation if you suspect you have been overcharged for prescription medications covered by your insurance.

Legal cases related to prescription overpayment often revolve around issues such as:

• Incorrect co-pay amounts: Did you pay more than the agreed-upon co-pay for your medications?
• Unfair insurance practices: Was your insurer’s cost-sharing structure transparent and fair?
• Pharmacy pricing discrepancies: Did the pharmacy charge more than the actual cost of the medication?

Filing a claim can help you recover what you’ve overpaid and convey that unfair pricing practices won’t be tolerated.

How to Take Action: Start with a Free Case Review

The sooner you take action, the better your chances of recovering any money you've lost.

Here’s How You Can Start:

• Gather your prescription records and receipts.

• Review your insurance statements for any discrepancies.

• Contact our team for a free, private case review.

• Discuss your eligibility for compensation with a qualified attorney.

Taking these simple steps could be the start of recovering the money you overpaid for your prescription medications.

You don't have to be a victim.

Prescription medication overpayment is an issue that affects millions of Americans, but you don't have to be a victim. If you think you've been overcharged for your medications, now is the time to act.