Prorated Pharmacy Copays Now Available

In many situations, patients who fill a prescription for less than a month’s supply will have their copay prorated to the number of days they fill it.  This means that if a member wants to fill a 15 day supply (instead of a 30 day supply) of an eligible medication, they will only pay half of their copay. 

  • This is especially useful for members who are starting a new medication and want to try a short course in case they experience a side effect that prevents them from using the full month. 
  • It is a great way to prevent waste because once a medication is dispensed, it cannot be returned to the pharmacy. 
  • This is also helpful to allow pharmacies to synchronize members’ medication refills to reduce the number of trips they come into the pharmacy.

For Quartz Commercial members, medications filled for less than a 28 days’ supply will be prorated as long as the drug is classified as a “maintenance drug” by First Data Bank, and it is not an eye drop, topical (cream, ointment, etc.), or insulin product. For Quartz Medicare Advantage members, medications filled for less than 30 days will be prorated as long as the medication is a solid, oral, non-antibiotic drug not dispensed in special packaging.

A senior woman holding pills in one hand and reading prescription information in the other

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