Frequently Asked Questions

What is Rx Savings Solutions and how does it work?

Rx Savings Solutions is a free, confidential online tool that shows you and other family members on your health plan ways to save money on medication(s). Our software is connected to your health plan and it looks at the medications you take and finds options that may save you money. Your online account shows which lower-cost prescriptions are available and lets you compare prices. It also automatically lists any medications you’ve filled so everything’s in one place. It’s like having your own personal pharmacist right by your side. Best of all, we’ll contact you anytime you’re spending too much on prescriptions you’re currently taking or new ones you’re prescribed in the future.

Is Rx Savings Solutions simply a drug look-up tool?
No, we give members the ability to search for any medication to find the best prices and any lower-cost but therapeutically equivalent options available. However, what separates our solution from other tools is the ability to proactively notify members via email and text message about savings opportunities they already have.
Is Rx Savings Solutions a PBM? Will you replace my PBM?

No, we are not a pharmacy benefit manager, nor do we replace yours. We are an additional pharmacy service that layers over and works in conjunction with your existing program to help navigate and optimize your prescription benefit. We are PBM-agnostic and work with many of the largest PBMs.

Will you alter or replace my existing health plan?

No, we are also health plan-agnostic and work within your existing plan design. In fact, many of our customers are health plans.

We have maximized our pharmacy program. How can you find savings?

We find additional savings beyond your plan and formulary design by comparing member claims data against available savings opportunities that come from various therapeutic equivalents, dosage optimizations, brand-to-generic and generic-to-generic substitutions, alternate fulfillment channels and other recommendations curated by our in-house pharmacists. Unlike most pharmacy plan designs, our solution is dynamic and continually updated with the newest pricing information, so savings opportunities can be realized immediately rather than the next plan year.

How can my members trust your recommendations?

Rx Savings Solutions was founded by a pharmacist and is staffed with in-house, licensed pharmacists who provide ongoing oversight. Our “suggestions engine” is maintained and constantly curated by this pharmacy team. We use the Gold Standard clinical database, which is updated daily and includes all pertinent U.S.-approved drug product data and images with professional monographs and corresponding patient education. All recommendations are based on the same peer-reviewed, evidence-based compendia that hospitals, health plans, Medicare, Medicaid, and PBM’s use to establish coverage criteria and evaluate approved/non-approved uses.

What experience do you have with groups our size and in our industry?

The beauty of our offering is that it has proven to work for groups of all sizes, regardless of industry, PBM, or whether the client works with a consultant. We currently serve groups as small as 5,000 members and as large as 700,000, with demonstrated success in a variety of industries, including health plans, government, healthcare, financial services, retail, manufacturing and communications. Our MidMarket solution is available for groups between 500 - 10,000 members. We work with a growing number of consultants and welcome their involvement in the discussions around our solution.

How will you contact my members? What if I want to control the message?

Email is currently the primary medium for member communications and outreach. This includes initial member engagement (registration) campaigns as well as routine follow-up emails alerting members to savings opportunities. Critical to our proactive approach is the ability to contact members, upon their approval, via text messaging. We offer turnkey as well as custom-designed and client-approved marketing plans, depending to what degree the client prefers to control the message.

How do you handle members who don’t have valid email addresses?

Valid email addresses are necessary for members to take full advantage of the Member Portal and the array of services available. However, to encourage member engagement and registration, we often utilize printed promotional and informational materials, reminders and direct mail to communicate with populations for whom email use is neither common nor practical during the business day. Members may also call our Member Services team for assistance with registering, savings opportunities, prescriber and pharmacy interactions, and any questions they may have.

What are the most common switches your solution recommends?

The majority of recommendations consist of therapeutic equivalent alternatives and dosage optimization for chronic medications, as well as simple price shopping. Rx Savings Solutions utilizes a patented algorithm that exhausts all clinical and fulfillment alternatives in search of a savings. About 75% of savings are the result of a clinical suggestion and 25% of savings come from fulfillment changes.

What are your savings opportunities for specialty medications?

By definition, specialty medications typically don’t have as many therapeutic alternatives available as traditional products do. However, we advise and educate members on specialty medications to maximize whatever generics or biosimilar options are available, and to utilize available manufacturer coupons and rebated products that are commonly available in the specialty class. In cases where a mature or saturated therapeutic class exists, members are steered to the lowest-cost medications with the same indications.

How do you differ from medication therapy management (MTM)?

The biggest difference is purpose and function. MTM programs exist to optimize therapeutic outcomes by actively managing drug therapy and by identifying, preventing and resolving medication-related problems. We exist to provide personalized and proactive pharmacy guidance within the existing benefit, with the goal of saving the member money. Essentially, the respective goals are clinical vs. financial optimization.

How does this work with my health insurance and pharmacy options?

Rx Savings Solutions offers a service that helps lower your prescription drug costs. This service doesn’t change anything about your current insurance plan, pharmacy preferences or other benefits. Our software is linked to your health insurance plan information so it can customize ways to lower your out-of-pocket prescription drug costs.

How can Rx Savings Solutions save me money?

We find all the lower-cost medication options that treat your condition and are covered by your insurance. You and your doctor can decide what’s best for your health and budget. Here are just a few ways you might be able to save money:

  1. Generic forms of name-brand drugs

  2. Better prices at different pharmacies or through mail-order

  3. Equally effective medications that treat the same condition but cost less than your current prescription
How will I know if I can save money?

There are two easy ways to see if you can save money on your prescriptions.

  1. Your Rx Savings Solutions account will always show any savings opportunities you may have on your current prescriptions. Anytime you start taking a new prescription that’s covered by your insurance plan, it will automatically show up on your account with any options you might have to save. Plus, you can use your account to proactively search for pricing on any medication before your doctor gives you a prescription.

  2. We’ll contact you if there’s a way to lower your prescription drug costs. You’ll receive these messages—email, phone, text, letter—if there’s a chance to save money on current prescriptions or new ones you start taking in the future.
How do I use Rx Savings Solutions when I’m prescribed a new medicine?

Your account has a search feature to compare pricing options on medications before your doctor writes a new prescription. Anytime you start taking a new prescription that’s covered by your insurance plan, it will automatically show up on your online Rx Savings Solutions account (unless you used a coupon card that takes you outside of insurance). You’ll be able to see any options you might have to save money, and you’ll receive a message if you’re paying too much.

How does Rx Savings Solutions know which medications I'm taking?

Rx Savings Solutions uses pharmacy claims data provided by your health plan and/or prescription insurance. This confidential data is securely transferred to our software on a regular basis so that we can match the medications you take with any available alternatives that will save you money.

How is this different from a coupon or discount program for prescription drugs?

Since our software is linked to your health plan, everything we do is personalized for you. We know the details of your prescription drug benefits and use that information to find the lowest cost options covered by your insurance plan.

Can dependents on my health plan use Rx Savings Solutions?

Yes! Your Rx Savings Solutions online account will automatically show prescription drug information for any minor-age dependents on your health plan. Adult dependents are required to activate their own Rx Savings Solutions account and can then give you access to view their information.

Can I trust Rx Savings Solutions to secure my personal information?

Rx Savings Solution will not expose your personal health information to anyone, including your employer. Our business depends on holding your personal health information in the strictest confidence. Like your health insurance carrier, your doctor(s) and your pharmacy, we are legally bound to the Security Rules under the Health Insurance Portability and Accountability Act of 1996 (HIPAA Security Rules). To learn more about how Rx Savings Solutions handles your information, please see our Privacy Policy.

What information of mine do you have?

By using Rx Savings Solutions, members consent to our collection/use/disclosure of their personal information, but only for the purposes of providing our service. This includes claims information, such as the prescriptions you filled, how much you paid, and which pharmacy you utilized. We may automatically gather and keep track of information about a member’s visit to the member portal and their activity. Unlike many websites, we track this only for activity within our own site, never other web browsing.

Do you sell my information?

No, Rx Savings Solutions will not expose your personal health information to anyone, including your employer. We do not sell or share your information for commercial purposes with any third-party marketing services. We may use and disclose health information with service providers for data analytics purposes, but it is always “deidentified,” i.e. not attached to your identity and contains no protected health information.

As you add features, how do you ensure my privacy?

Before we utilize a new feature or even put out a new informational piece, like this FAQ, we review it with our legal compliance team to ensure we are fully protecting your data. For example, while Rx Savings Solutions is fully HIPAA-compliant, voice assistant devices are not. Therefore, even though a user can delete data held by a voice assistant device, there is still a risk that health information could be inadvertently disclosed to an unauthorized party if a voice assistant device is used to access our service.

Why can't everyone use Rx Savings Solutions?

We want to build and deliver only the best, most effective solution possible. We want to make it accessible to the most people possible. That means partnering with employers and health plans so that we can provide the most personalized and precise solution for each member.