Dispensing Fee
A dispensing fee is the professional service charge that a pharmacy adds to the cost of a prescription drug when it is filled. This fee covers the pharmacist’s time, expertise, and services such as verifying the prescription, reviewing potential drug interactions, preparing the medication, and providing counselling on proper use. Each pharmacy sets its own dispensing fee, which can vary based on location, prescription type, and the pharmacy’s policies.
In most health insurance plans, the dispensing fee is considered part of the eligible prescription cost and is reimbursed according to the plan’s drug coverage rules. However, some plans cap the amount reimbursed for dispensing fees, meaning you pay the difference if the pharmacy charges more than your plan allows. For maintenance medications, insurers often encourage using 90-day supplies or preferred pharmacies to minimize repeated dispensing fees.
Example:
If a prescription costs $40 for the medication and the pharmacy adds a $10 dispensing fee, the total charge is $50. If your plan covers 80 percent of eligible drug costs, the insurer reimburses $40, and you pay $10 out of pocket.
What to Watch For:
Compare dispensing fees among pharmacies, as they can vary widely. Some plans limit reimbursement to a maximum fee per prescription, such as $8 or $10. If your plan includes a preferred pharmacy network, filling prescriptions there may eliminate or reduce your out-of-pocket costs. Always ask your pharmacist for a detailed receipt that separates the drug cost from the dispensing fee for accurate claim submission
