As for pharmacies, it’s often because insurance companies didn’t do online billing. People would have to pay for their drugs, submit a claim by mail (or drop o

As for pharmacies, it’s often because insurance companies didn’t do online billing. People would have to pay for their drugs, submit a claim by mail (or drop off at their employer) and get a cheque. Sometimes they could send the cheque to the pharmacy directly. Sometimes the pharmacy (or dentist or whoever) would submit the claim for you. Credit cards reduced the necessity of this (so you’re not floating the cost, but the pharmacy is directly until they get paid by the insureco). There’s still some people that will pay cash in Canada for their meds and submit their receipts so they can get that 1-2% in points, but that doesn’t really work where drug prices aren’t controlled. As pharmacy chains and insureco increasingly become one and the same, and the insureco can take its time paying out-of-network pharmacies to starve them a bit.