2

Insurance policy set up by the workplace requires us to fill prescriptions through a specific mail order vendor and denies coverage of prescriptions through other retail vendors (Walgreens, CVS, etc)

Is this legal?

Seems like it takes away consumers choice, and there are valid reasons for not wanting mail delivery, including, not always being in or near the same address.

Also, I've heard that they use and send out older expired medicine but have no way of confirming or validating the truth of that.

Is there any legal recourse here or are we just stuck with this?

  • I've never heard of Express Scripts sending old or expired medicine. If that happens to you (and you experienced harm because of it), you should talk to a lawyer and see if there's a viable lawsuit. – Max Feb 13 at 17:56
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It is legal and quite common. Your choice as consumer is at the point of selecting insurance company. If you dislike ES enough, that would be a reason to select a different insurance company. It would be surprising if your ES contract disallows pharmacy pick-up, but even if it did, that would also be legal.

This does not mean that the government doesn't have the power to break up Express Scripts, under anti-trust laws. There is no clear rule regarding how successful a company can be in attracting customers.

  • Hellyale did say the policy comes from the employer so it may not feel so much like a free choice. For example, it is legal (but uncommon) for an employer to require you to join the company plan [1]. You can also try calling Express Scripts and see if they can accomodate your particular living arrangement. I know lots of snowbirds who have it all worked out. If you can't do so, you can also call the insurance plan and try to work something out. [1] npr.org/sections/health-shots/2015/03/11/392177224/… – Max Feb 13 at 18:05

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