# What strategy motivates prescription insurance companies to limit how many pills you can get? **URL:** \ **Category:** Great Debates\ **Created:** [October 14, 2015, 4:56pm UTC](https://boards.straightdope.com/t/what-strategy-motivates-prescription-insurance-companies-to-limit-how-many-pills-you-can-get/734646 "2015-10-14T16:56:46Z")\ **Posts on this page:** 7\ **Page:** 2
**Author:** ![doreen](https://avatars.discourse-cdn.com/v4/letter/d/858c86/32.png) [@doreen](https://boards.straightdope.com/u/doreen)\ **Post date:** [October 18, 2015, 1:38pm UTC](https://boards.straightdope.com/t/what-strategy-motivates-prescription-insurance-companies-to-limit-how-many-pills-you-can-get/734646/21 "2015-10-18T13:38:55Z")
> [@Balthisar](#): > > Wait, other than Medicare something-or-other, who has prescription insurance that’s not part of overall health insurance? I’ve only ever had medicines as part of a health plan. Depends on exactly what you mean by a “plan”. I’ve always gotten all of my health insurance through my employer, but it’s not uncommon for different coverage to come from different places. For example, one job had prescription and dental coverage through my union, while I had a choice of about ten different companies for medical/hospital. My son has a choice of a number of different plans for medical/hospital , but his pharmacy benefit manager is Aetna no matter which plan he chooses. My current insurance has one company for medical, another for hospital, a third for prescription and a fourth for mental health/substance abuse. ---
**Author:** ![Napier](https://avatars.discourse-cdn.com/v4/letter/n/ce73a5/32.png) [@Napier](https://boards.straightdope.com/u/Napier)\ **Post date:** [October 18, 2015, 9:44pm UTC](https://boards.straightdope.com/t/what-strategy-motivates-prescription-insurance-companies-to-limit-how-many-pills-you-can-get/734646/22 "2015-10-18T21:44:41Z")
> [@Napier](#): > > If they want me to take all my meds, why would they only dispense 96 hours worth at a time? > [@Fat\_Chance](#): > > First, I did say that I was talking about strategy around maintenance meds, not acute meds like an antibiotic. > > Would need more info to make a guess at your situation - > > - who would only dispense 4 days worth, the local pharmacy? > - did they say that was because of rules from your rx insurance? > - what was the quantity that the doctor prescribed? (something like a zpack is only 4 days anyway) The local pharmacy would only dispense 4 days worth. They say it’s because of the rules from the rx insurance company. The doctor prescribed maybe 15 or so days worth, so I had to go back at least 4 times. I remember the weekend drifting around with respect to the 4 day cycle because I went back so many times. ---
**Author:** ![Balthisar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/balthisar/32/2825_2.png) [@Balthisar](https://boards.straightdope.com/u/Balthisar)\ **Post date:** [October 19, 2015, 1:41am UTC](https://boards.straightdope.com/t/what-strategy-motivates-prescription-insurance-companies-to-limit-how-many-pills-you-can-get/734646/23 "2015-10-19T01:41:27Z")
> [@doreen](#): > > Depends on exactly what you mean by a “plan”. I’ve always gotten all of my health insurance through my employer, but it’s not uncommon for different coverage to come from different places. Today I learned. Thanks. ---
**Author:** ![PhillyGuy](https://avatars.discourse-cdn.com/v4/letter/p/ed655f/32.png) [@PhillyGuy](https://boards.straightdope.com/u/PhillyGuy)\ **Post date:** [October 19, 2015, 1:52am UTC](https://boards.straightdope.com/t/what-strategy-motivates-prescription-insurance-companies-to-limit-how-many-pills-you-can-get/734646/24 "2015-10-19T01:52:33Z")
> [@Napier](#): > > If they want me to take all my meds, why would they only dispense 96 hours worth at a time? Is your insurance company non-profit or for-profit? If for-profit, I guess the answer is obvious. ---
**Author:** ![Poto](https://avatars.discourse-cdn.com/v4/letter/p/7ab992/32.png) [@Poto](https://boards.straightdope.com/u/Poto)\ **Post date:** [October 19, 2015, 1:58am UTC](https://boards.straightdope.com/t/what-strategy-motivates-prescription-insurance-companies-to-limit-how-many-pills-you-can-get/734646/25 "2015-10-19T01:58:09Z")
It’s like real estate. If they have you go to the pharmacy, they have to split the profit. If they dispense by mail, they ARE the pharmacy, they get 100% of the fee they bill to employer or other source that pays the actual bill. Most employers over 5000 employees are self insuring. ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [October 19, 2015, 7:20am UTC](https://boards.straightdope.com/t/what-strategy-motivates-prescription-insurance-companies-to-limit-how-many-pills-you-can-get/734646/26 "2015-10-19T07:20:24Z")
The company I worked for switched to a new insurer who instituted a change in prescription processes, to save money: All prescriptions when filled include a dispensing fee (In Canada, IIRC, something like $10.). The more pills for one dispensing fee, the cheaper it is. So for regular ongoing prescriptions, they recommend 3 months at a time. For new prescriptions, they recommend only 30 days at a time. Today, many physicians prescribe by hit-and-miss. So if a new prescription is given, but then abandoned or changed due to side effects or inefficacy, it will usually happen within 30 days. As a result, giving more than 30 days’ pills with initial use is likely to cost a lot in wasted meds. Of course, pills that are likely to be abused volume may be limited by law or physician society rules. ---
**Author:** ![Kevbo](https://avatars.discourse-cdn.com/v4/letter/k/e47774/32.png) [@Kevbo](https://boards.straightdope.com/u/Kevbo)\ **Post date:** [October 19, 2015, 3:27pm UTC](https://boards.straightdope.com/t/what-strategy-motivates-prescription-insurance-companies-to-limit-how-many-pills-you-can-get/734646/27 "2015-10-19T15:27:00Z")
The prescription plan I was on only allowed a 30 day fill at a bricks-and-mortar pharmacy. This was done to encourage you to fill long term prescriptions mail order. Both the hassle reduction and lower prices were used as incentives. Changing jobs caused a gap in coverage, so I shopped for the best deal, and it turns out I can get the meds for half what the prescription plan rate was. But I waited just a little long to order them, so I filled one last month at CVS with no insurance. Holy shit! That cost 12X as much as the deal I found online. My point would be that the prescription plans aren’t always a good deal, and it is worth shopping fro the best deal on long-term meds. There are web sites and apps for this. The one I used is called Good Rx. [Previous page](https://boards.straightdope.com/t/what-strategy-motivates-prescription-insurance-companies-to-limit-how-many-pills-you-can-get/734646.md?page=1)