ie a pharmacy will take insurance A but not insurance B, forcing someone with insurance B to look at other pharmacies or pay a greater amount of money out of pocket.
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Whether a pharmacy or doctor will “take” an insurance just depends on whether they are willing to deal with the insurance to bill them for you. Each insurance has its own rules for billing, coverage, and preauthorization, and many doctors and pharmacies don’t want to have to deal with all of the difference processes and each of their timelines. You can always pay the bill upfront then ask your insurance to reimburse you and you **should** end up in the same situation as if the doctor bills them for you (though they will probably be “out of network”).
There is also the very important “in network” aspect, which is whether the doctor or pharmacy has a contract with a specific insurance. These contracts will include terms such as how much the insurance will pay for a given procedure or medication, and will almost always prohibiting “balance billing”. Balance billing is where the doctor or pharmacy can bill the patient for any difference between what their charge and their insurance agrees the procedure costs, which is often not the same as what the insurance will pay – namely, deductibles and copays make that final difference.
Any doctor or pharmacy that is “in network” will “take” the insurance, but many that are “out of network” will also “take” the insurance, though you will typically pay more for the same procedure.
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