Release 3
2024 Program Updates — No longer sharing over-the-counter supplements
For Needs started on or after November 1, 2024, Samaritan will no longer share over-the-counter supplements.
There are a few conditions for which a licensed medical provider might write a prescription for a supplement. If a licensed medical provider prescribes a supplement, it can be shared as part of a Need as long as it meets these criteria:
- It must have an actual written prescription from a licensed medical provider. (Not just a recommendation.)
- It must be filled at a pharmacy by a licensed pharmacist, using that prescription.
- It cannot be an over-the-counter product.
Two examples of prescribed supplements would be iron infusions for anemia or prescription-type calcium drugs for osteoporosis.
A pharmacy is defined as a service with licensed pharmacists that can legally fill written prescriptions from a licensed medical provider.
Some time ago we began sharing non-prescribed (or over-the-counter) supplements in an effort to offset the cost of presumably more expensive prescribed treatments. However, our data over time has shown that sharing these non-prescribed supplements has not decreased the cost of the Needs. Since 2016, supplement sharing has risen by 300 percent, while the amount of incoming bills for prescription drugs hasn't decreased.
Therefore, beginning with Needs started on or after November 1, 2024, we will share only those supplements that have been prescribed for a specific condition by a licensed medical provider and are filled at a pharmacy (not over-the-counter). These prescriptions will be subject to the standard 120-day prescription window. This is part of our ongoing effort to minimize Share amounts.
Frequently Asked Questions
The goal is to minimize Share amounts to make Samaritan more sustainable. We have been carefully analyzing several bill categories to determine whether past strategies have lived up to the current challenges in the economy.
Non-prescribed or over-the-counter supplements is a category that has not proved sustainable for sharing. We originally decided to share non-prescribed supplement costs when it seemed it would help drive down member costs for prescriptions and cancer Needs. Unfortunately, the cost of supplements has increased significantly, and sharing them has not reduced the overall cost percentages of prescriptions or cancer Needs. Instead, non-prescribed supplements have increased the burden on the whole membership and is therefore a category we must remove, beginning with any Need started on or after November 1, 2024.
Most members prefer to keep monthly Shares as low as possible. We believe removing non-prescribed supplements from sharing will help us do this and will also lessen the possibility of proration.
Yes. If a supplement is prescribed by a licensed medical provider and filled by a pharmacy (i.e., is not an over-the-counter supplement), it can be shared as part of a Need. These prescriptions are subject to the established 120-day prescription window.
Any Need you started prior to November 1, 2024, can still have either prescribed or recommended supplements shared according to the guidelines that were in place when you started the Need. Section VIII.B.35. of the Guidelines provides the sharing parameters when a supplement is not prescribed.