We Don’t Cover Specialty Drugs (Wink Wink)

“It’s not fair!” says Status Quo Sally, “Our competition is stealing our business with lower rates and better benefits. They can afford to because they are not covering specialty drugs!”

But alas, the truth is somewhat different. The competition is indeed covering specialty drugs through a sidecar agreement no one sees. They guarantee no one will ever be turned down for specialty drugs, period!

“It ain’t lying if you’re telling the truth!” says the underwriter.

If a member can’t get a specialty drug through a manufacturer’s patient assistance program, the sidecar agreement kicks in and pays for the drug.

Being sneaky is an artform.