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Carving out pharmacy benefits from the medical benefits plan

Carving out vs. Carving in pharmacy plans

Carving out pharmacy benefits means an employer separates those benefits from the medical benefits plan. When this happens, the employer negotiates directly with a Pharmacy Benefit Manager (PBM) to manage the prescription drug benefits. Conversely, carving in pharmacy benefits means the benefits are not separate from the medical benefits plan, typically done by a large medical health plan or a third-party administrator.

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