What is a Prescription Carve-Out?
A prescription (RX) carve-out is when you remove the prescription plan for the carrier administering your health plan. You no longer would rely on their pharmacy plan but could customize your plan directly with a pharmacy benefit manager (PBM.)
Why would you do this?
Savings from RX carve-outs can be substantial. At a minimum you will be able to retain all of the prescription rebates you don't have today (typically worth 20% of your expense) and you'll be able to customize your formulary, network and utilization rules to contain your costs for the long term. Keep scrolling to learn more.