Flexible solutions driven by cost containment.

How MaxCare lowers costMaxCare combines 100% pass-through pricing with programs that act on the claims that drive cost: utilization management, specialty assistance, reference pricing, combination-drug blocking and medical rebate capture. Every program is reported to the plan sponsor in plain language, so you can see what each one saves.

1. 01

   Clinical Services

   A flexible approach focused on member needs and cost containment: the appropriate medication at the right cost. With the MaxCare difference, average combined savings exceed 30%, and many cases eliminate out-of-pocket costs for members.

   30%+average combined savings

2. 02

   Cost Containment (MaxForward)

   A suite of targeted programs that manage and mitigate drug expenses for plan sponsors and members, from patient assistance to international sourcing.

   4programs: Access, Assist, Protect, Choice

3. 03

   Medical Rebate Management

   Captures manufacturer rebates on specialty drugs billed under the medical benefit, with reporting down to the NDC level.

   110+injectable medications covered

4. 04

   SmartBlock

   Identifies high-cost combination prescriptions and replaces them with cost-effective alternatives. Continually updated for new medications.

   $147Ksaved on one drug for one patient in 2024

5. 05

   MaxChoice

   A reference price program for drug categories with equally safe, effective, lower-cost options. It gives patients choice while easing plan expenses.

   5–15%typical savings of overall plan cost

6. 06

   MaxProtect

   Helps employees get vital specialty medications while curbing plan expense. We verify eligibility for manufacturer assistance, handle enrollment and re-enroll when needed.

   35%average reduction in specialty plan costs