Tools for Price Shopping Specific Procedures & Meds

Hi All, I am brand new to this sub, but I am not new to the insurance game.

I am looking at making a switch from marketplace to small group (biz owner w/ enough participating employees, finally). Shopping before selecting a provider is always a giant pain in the arse. We have autoimmunes in our fam w/ several known medical needs, some of which are formulary/Rx questions, and the others are mixed bags (part formulary/Rx, part DME, part inpatient procedure, etc.). Brokers tend to know nothing, agents tend to know nothing, all internal provider reps seem to know nothing, and I usually cannot even find the correct formulary posted online until I am already a member with an account. So…

Any suggestions for how I can price out the meds and multi-faceted procedures before choosing a provider? It is not as simple as looking at the plan summaries, as these never show what tier the meds would be nor how the multi-faceted procedures would be run. For example, an inpatient infusion with a drug…is that specialist? ER? hospital? Rx? It's just not clear. TIA for any help/guidance.

submitted by /u/Brie_Sweetly
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