Independent Pharmacy Benefit Management

The Benefits Are Clear.

MaxCare is the independent PBM that puts your money back where it belongs, in your plan. No spread pricing. No conflicts of interest. Just the lowest net cost in pharmacy benefits, backed by clinical expertise and community care.

SAVINGS YOU CAN SEE. SUPPORT EMPLOYEES CAN FEEL.
100%
Drug Discount Pass-Through
100%
Rebate Pass-Through
0%
Spread Pricing
Every dollar in drug discounts and manufacturer rebates flows directly to your plan, not our bottom line. MaxCare is paid through a single, all-in administrative fee, so you always know what you're paying for.
Why Self-Insured Employers Choose MaxCare

Most PBMs profit when your drug costs go up. We profit when they go down.

The traditional pharmacy benefit management model has a problem: most PBMs make money on spread pricing, charging your plan more than they pay the pharmacy and keeping the difference. They earn rebates from drug manufacturers and share only a fraction with you. The incentives are misaligned.

MaxCare was built differently. As an independent PBM with no ties to an insurer, mail-order pharmacy, or specialty drug company, we have one goal: reduce your total pharmacy spend at the source. Our success is measured by your savings, and we'll prove it on paper.

Learn How Pass-Through Pricing Works

Traditional PBM vs. MaxCare

Traditional PBMs keep the spread between what you pay and what the pharmacy receives
MaxCare charges zero spread, you pay what the pharmacy is paid
Traditional PBMs share only a fraction of rebates
MaxCare passes through 100% of manufacturer rebates
Traditional PBMs steer members to pharmacies they own
MaxCare is fully independent, no insurer, no mail-order, no conflicts
Traditional PBMs bury their fees across spread pricing, retained rebates, and charges you never see
MaxCare charges one transparent, all-in administrative fee, so you always know exactly what you're paying for
For self-insured employers and the brokers who represent them, that difference is worth millions.
What MaxCare Delivers

Four Commitments. One Aligned Model.

Delivering True Lowest Net Cost

Lowest net cost isn't a marketing phrase at MaxCare, it's a contractual commitment. We reduce total pharmacy spend by passing through 100% of drug discounts and 100% of rebates directly to your plan. Our clinical programs target the highest-cost categories where most PBMs leave money on the table.

Clients see 10–30% savings on specialty medications. Members with infusion therapy save 30–50% per treatment.

The Independent PBM Built to Work for You

MaxCare is not owned by an insurance company, mail-order pharmacy, or specialty drug distributor. Every clinical recommendation, every formulary decision, and every vendor relationship is made with a single priority: what is best for your plan and your members. No side deals. No hidden revenue streams. Instead, our compensation is a single, transparent administrative fee, one clear line item you can see, evaluate, and budget for, with no surprises.

MaxCare earns a 3:1 ROI for clients through proactive utilization management, savings that go directly back to your plan.

Pharmacy Benefits Managed With Clinical Rigor

Pharmacy costs can't be controlled with contracts alone. MaxCare's clinical team actively manages your highest-cost claims before they become budget problems, specialty utilization review, GLP-1 oversight, biosimilar transition support, rare disease management, and concurrent and retrospective DUR.

13% additional specialty savings through proactive clinical insight. Members save 25–55% off AWP through 340B program access.

Community Pharmacy Access, Built Into the Model

Big-box PBMs push members toward mail-order and specialty pharmacies they own. MaxCare supports the community pharmacy network, independent and regional pharmacies that employ local staff, know members by name, and deliver care that feels personal.

For employers with dispersed workforces and rural members, community pharmacy access isn't a nice-to-have. It's essential.
Clinical Programs

Specialty Costs Don't Have to Be a Mystery.

Eleven targeted programs that target pharmacy spend where it grows fastest.

Specialty Coupon ManagementCapture manufacturer assistance programs to reduce member and plan cost
High Dollar ExclusionRedirect high-cost specialty claims to lower-cost alternatives
Biosimilar ManagementAccelerate biosimilar adoption with clinical and formulary guidance
Proactive Utilization ManagementIdentify cost-driving patterns before claims compound
Rare Disease Drug ManagementSpecialized oversight for ultra-high-cost rare condition therapies
Site-of-Care OptimizationMove infusion therapies from hospital outpatient to lower-cost settings
GLP-1 / Weight Loss ManagementClinical protocols to manage the fastest-growing category in pharmacy spend
Concurrent & Retrospective DURDrug utilization review that catches problems in real time and over time
Adherence ManagementImprove member outcomes and reduce total plan cost through adherence support
340B Program AccessSave 25–55% off AWP for eligible members through community-based 340B pharmacies
Medical Rebate ManagementCapture untapped rebates on 110+ injectable medications spanning 1,750 unique NDCs
View All Clinical Programs
Medical Rebate Management

The Rebates Most Plans Never See? We Capture Them.

Pharmaceutical manufacturers offer rebates on medical claims that go untapped, few organizations have the expertise or qualifications to submit claims and collect incentive funds on specialty medications billed under the medical benefit.

MaxCare's Medical Rebate Management captures rebates currently offered on more than 110 injectable medications spanning 1,750 unique NDCs. It's a direct cost offset for your plan, without added administrative burden or operational disruption. For brokers and TPAs, it's also a differentiator and a potential new revenue stream.

Ask About Medical Rebate Management
36%
of specialty drug spend appeared on medical claims in 2023, outside the reach of a standard pharmacy benefit
Aggregator ManagementWe handle negotiating, qualifying, submitting, and tracking, so you don't have to
Technology & ExpertiseState-of-the-art technology ensures you capture every eligible rebate, including those frequently overlooked
Payment & Forecast ReportingDetailed reports down to the NDC level, full visibility into your rebate earnings
Transparency & OptimizationClear insights and advanced analytics uncover new rebate opportunities
Discover the MaxCare Advantage

Hear It From Our Leadership

We take a consultative approach, partnering with employers to effectively manage their pharmacy benefit, proactive, tailored, and built to control prescription costs.

John Crumly, Ph.D., M.H.A.Chief Executive Officer of MaxCare
J.J. Peek, PharmDVice President of MaxCare
Who We Serve

Built for the People Who Own the Pharmacy Decision

For Benefits Brokers

A PBM You Can Put Your Name On

  • Pass-through pricing with full audit rights
  • Rebate transparency
  • A single, transparent administrative fee that's easy to present and easy for clients to compare
  • Medical rebate management, a potential new revenue stream for your organization
  • Proactive clinical reporting
  • Dedicated account support
Partner With MaxCare
For Self-Insured Employers

Take Back Control of Your Pharmacy Spend

  • 100% drug discount & rebate pass-through
  • 0% spread pricing
  • One transparent, all-in administrative fee, easy to evaluate and budget
  • Clinical programs targeting your highest-cost claims
  • Plain-language reporting built for HR and finance leadership
Request a Pharmacy Spend Analysis
What Our Partners Say

Trusted by Employers. Recommended by Brokers.

Join the ranks of self-insured employers who trust MaxCare for managing their pharmacy benefits.

Hear how our partners manage their pharmacy benefits with MaxCare.

From groups as intimate as 100 members to as vast as 10,000, effective solutions, easy-to-understand plans, and contracts that always keep the members in focus.

Frequently Asked Questions

Straight Answers About Pharmacy Benefits

Plain-language answers, the way pharmacy benefits should be explained.

What is MaxCare, and what does MaxCare do?
MaxCare is an independent pharmacy benefit manager (PBM) based in Oklahoma City that helps self-insured employers reduce total pharmacy spend. MaxCare passes through 100% of drug discounts and manufacturer rebates, charges zero spread pricing, and manages high-cost claims with dedicated clinical programs.
What makes MaxCare different from other PBMs?
Unlike traditional PBMs, MaxCare is not owned by an insurance company, mail-order pharmacy, or specialty drug distributor. That independence removes the conflicts of interest that drive up costs, no spread pricing, no retained rebates, no steering members to PBM-owned pharmacies.
How does MaxCare reduce pharmacy costs for self-insured employers?
MaxCare reduces costs at the source: 100% pass-through of discounts and rebates, plus clinical programs targeting the highest-cost categories, specialty coupon management, biosimilar adoption, site-of-care optimization, GLP-1 management, and 340B access saving members 25–55% off AWP.
What is pass-through pricing in pharmacy benefit management?
Pass-through pricing means the plan pays exactly what the pharmacy is paid, the PBM keeps no spread, and every manufacturer rebate flows back to the plan. It's the pricing model that aligns the PBM's incentives with the employer's.
How does MaxCare's flat administrative fee work?
MaxCare charges a single, flat all-in administrative fee for its services, disclosed up front and kept separate from your drug costs. It doesn't rise and fall with your drug spend, and there's no spread pricing or retained rebates layered underneath it. That means you know exactly what you're paying for, which makes it easier to evaluate your true pharmacy costs and plan your benefit spend with confidence.
Does MaxCare work with independent community pharmacies?
Yes. MaxCare supports the community pharmacy network, independent and regional pharmacies that know members by name. For employers with dispersed workforces and rural members, that access is essential, and MaxCare's network keeps it open.
What clinical programs does MaxCare offer?
Eleven targeted programs: specialty coupon management, high-dollar exclusion, biosimilar management, proactive utilization management, rare disease drug management, site-of-care optimization, GLP-1/weight loss management, concurrent & retrospective DUR, adherence management, 340B program access, and medical rebate management.
What is medical rebate management, and how does MaxCare capture medical rebates?
In 2023, 36% of specialty drug spend appeared on medical claims, where manufacturer rebates typically go uncollected because few organizations are qualified to submit them. MaxCare's Medical Rebate Management captures rebates on more than 110 injectable medications spanning 1,750 unique NDCs, managing negotiation, qualification, submission, and tracking end to end, with payment and forecast reporting down to the NDC level.
About MaxCare

Independent by Design. Aligned to You by Choice.

MaxCare was founded on a simple belief: pharmacy benefit management works better when the PBM is on the same side as the employer. We are independent. We are transparent. And we are deeply committed to the employers, brokers, and members we serve, including the community pharmacies that have served them for generations.

HQ, Oklahoma City, OK Part of the PPOK family Strengthening independent pharmacy nationwide
“Pharmacy benefit management works better when the PBM is on the same side as the employer.”
MaxCare's founding principle

Ready to See What Transparent Pharmacy Benefits Look Like?

Get a no-obligation pharmacy spend analysis and see exactly what MaxCare can save your organization, in plain language, backed by data.