Even with insurance, prescription drug prices can shock you. Many Americans struggle to afford their medications, and a third are skipping doses because of the cost.
If you're looking to save on prescription meds, there are some viable options worth exploring. Comparing prices at various pharmacies, signing up for co-pay cards or patient assistance programs, and trying mail-order pharmacies can lower your out-of-pocket expenses.
So, how do you start? Have a conversation with your doctor about how to make your care more affordable. But, don't stop there. Review these tips on how you can proactively work to keep prescription costs in check:
See if a Generic Medication Works for You:
If you are shopping for insurance, research a insurance plan’s list of covered meds, otherwise called drug formulary during open enrollment. If you already have a plan that does not cover a drug you require, you may be asked to try a lower-tier drug (often a generic) which would save you money.
Generic medications are less expensive since those manufacturers do not have to pay for the research and development that the original pharmaceutical company bears. Once a medication has been on the market for approximately 20 years, other manufacturers can make a generic version. This time frame can vary depending on how long the original patent lasts and other factors like extensions. For instance, Zoloft costs around $504 for a month, but its generic version, sertraline, costs about $31.
However, if you have adverse reactions or no improvement on a lower-tier medication, ask your physician to appeal your insurance for the brand name if it works for you. If approved, the insurance will cover the medication at a higher rate.
Copay Savings Cards:
If you do need to take a pricey brand-name medication, look into Prescription Drug Savings Cards that you can obtain from your doctor, pharmacy, or simply research online. Some of these include GoodRx, WellRx, and OptumPerks.
Patient Assistance Programs:
You can also contact a drug’s manufacturer to see if they have a patient assistance program that can help offset the cost of their medication. You can locate the manufacturer of your medication simply by doing an online search for the brand name, or if you have prescription, pull information from the packaging label.
These programs are usually for people with commercial insurance, not Medicare or Medicaid. Check the drug manufacturer’s site or ask your pharmacist. Often, your doctor or pharmacy can give you a sign-up card, or you can sign up online and download a card to use at your pharmacy.
If you’re uninsured or underinsured, you may qualify for free or discounted meds through these programs. Some manufacturers may require proof of income and lack of insurance - yet others are more lenient to get you to try their product.
Compare Pharmacy Prices:
Prescription prices vary widely, even within the same area. CoPay Savings companies such as those listed above can help you compare costs at local pharmacies, so you don’t overpay.
Use HSA or FSA Funds:
You can use tax-free dollars from your HSA or FSA to pay for prescriptions. Remember that they usually have a "use-it-or-lose-it" rule, so spend that money before the year ends.
Pill Splitting (if Safe):
If your medication allows it, splitting the pills in half can save money. Just make sure it’s safe to do with your specific medication by asking your doctor or pharmacist.
Max out Allowable Amount of Medication:
Ask your doctor for a 90-day prescription and refills, or the maximum number of doses you can receive for the mediations you regularly take. You’ll likely pay less per dose and cut down on trips to the pharmacy.
Mail-Order & Online Pharmacies:
Mail-order services may offer better prices on medications you take regularly. Many insurance companies provide discounts if you opt in for mail-order meds.
Always be cautious that you are working with a reputable online pharmacy. Make sure they’re licensed to avoid counterfeit medications. Reputable alternatives to compare pricing include CostPlus Drugs founded by Mark Cuban, Amazon, and locations that have online options in addition to their brick and mortar locations, such as Costco.
Medicare Extra Help:
If you have Medicare Part D, you may be eligible for the Extra Help Program, which assists with prescription costs for individuals with limited income.
Check if You’re Eligible for Medicaid:
If you qualify for Medicaid, it can drastically reduce your prescription costs depending on your state’s program and your income level.
State Pharmaceutical Assistance Programs:
Some states offer assistance for residents who need help paying for their prescriptions. These programs vary by location, but it’s worth checking what’s available in your state.
In-Network Pharmacies:
Don’t get surprised with a whopping bill when you pick up your medication. Before you fill a prescription, make sure the pharmacy you’re using is in-network with your insurance. This saves you a significant amount on your out-of-pocket responsibility.
Doing some research to understand the options available to you can help keep the cost of medications from draining your wallet, allowing you still get the care you need.
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