April 13, 2024

Can You Get Reimbursed for Your Compounded Medications?

When you need prescription medication, finding out that standard medications won’t work for you can feel devastating initially. But when you visit a compounding pharmacy, you could obtain the custom medications you need to get your health back on track. 

You can visit The Healthy Choice compounding pharmacy to get your personalized prescription medication filled as soon as today. But be prepared. You might have to pay some out-of-pocket costs. Continue reading to find out more about reimbursement opportunities for compounded medications. 

Costs of Compounded Medications

The U.S. Food and Drug Administration (FDA) is responsible for approving prescription medications for use. While they do recognize the need for compounded medications, the vast majority of compounded drugs are not currently FDA approved. This is because they simply can’t examine every single personalized medication for safety and efficiency before they allow it to be used by a patient. 

With that being said, because most compounded drugs aren’t FDA approved, most insurance companies refuse to cover the costs of custom medications. However, some do cover the costs or provide opportunities for reimbursement of out-of-pocket expenses. 

Insurance companies that do cover the costs of compounded drugs can have strict and complex rules that impact whether your prescription is covered. For example, some insurers could deny your claim if specific ingredients are used. Your compounding pharmacy could then potentially find an alternative ingredient that delivers the same result and will be covered by your insurer. 

Every person’s health insurance policy is different. You can find out more about what you might have to pay for your compounded medicine after speaking with your compounding pharmacy and your health insurer. 

How Reimbursement for Compounded Drugs Works

Reimbursement of the costs you paid out of pocket for your compounded medication may or may not be possible through your insurer. Generally speaking, reimbursement may only be available when you use an in-network pharmacy. But if a pharmacy is filling a prescription for a compounded drug, it may be considered out-of-network. 

Insurance policies can be complicated. You can find out more about your reimbursement opportunities when you speak to your health insurance provider. 

Contact The Healthy Choice Compounding Pharmacy 

Compounded medications may not always be covered outright by your insurance company. But that doesn’t necessarily mean you can’t get reimbursed for any out-of-pocket costs you might have incurred. And when you are ready to get the custom medication you need to get back to your life, contact The Healthy Choice compounding pharmacy. You can reach us by phone at 914-238-1700 or through our convenient contact form.