For this February 2020 Healthcare Forum we’ll discuss practical strategies to reduce your out-of-pocket cost for medication. Unfortunately, many Americans, especially those on a fixed income, have to forego medications to pay for other necessities. A recent survey showed that more than 20% of middle- and upper-class Americans never fill their prescriptions for expensive brand name medications because of high cost. A recent example is the outlandish cost for an Epi-pen or even diabetic medications.
Here are simple-to-implement strategies for reducing medication costs.
Ways to Reduce Your Cost for Medications
- If You Have Medicare Insurance
- Under Medicare, prescription medications are covered in most Medicare Advantage Plans and in Medicare Part D Plans. “Doughnut” hole costs are decreasing and should end in 2021
- Every January, different Part D and many other plans add and delete certain drugs from their formulary. The cost of certain drugs, especially new brand name medications, can increase dramatically.
- In October, make a list of the medications you take. Then call the customer service department of the medication plan you have. Ask if your drugs will still be covered starting in January and if the cost will be increasing substantially. Find out if your monthly premium will change. Compare your current plan with other plans that have better coverage for your medications.
- Try Using Generic instead of Brand Medicines
- Ask your doctor about the advisability of switching to generics or other lower-cost drugs.
- If Brand is the only choice, ask your MD to submit an authorization request to get insurance to pay for the brand medicine.
- Consider Prescription Discount cards
- The cards are usually free.
- Provided by some 26 vendors such as: GoodRx; US Pharmacy Card; Discount Drug Network; ScriptRelief; SingleCare.
- With insurance coverage, use EITHER your insurance OR Discount card–check if Discount Drug Card gives lower costs than your insurance.
- See recent review: “Best Prescription Discount Cards”.
- Compare Different Pharmacy prices
- There may be cost-savings by checking prices at competing pharmacies.
- Check Patient Assistance Programs for Prescription Drugs
- Some pharmaceutical companies offer income-based help for people enrolled in Medicare prescription drug coverage (Part D)or commercial insurance or those with no insurance.Find out whether there’s a Pharmaceutical Assistance Programfor the drugs you take.
- Many states help pay drug plan insurance premiums and/or drug costs for those who qualify. Find out if your state has a State Pharmaceutical Assistance Program.
- Ask Your Doctor About Pharmaceutical Samples of Brand Medications Available in His/hers Office
- Try using this medication on a short-term basis to see if it is effective before investing in a longer-term prescription knowing that your insurance may not cover it.
- Consider Buying Medicines on the Internet – See our article 12/28/19 “Prescription Medications for Less”
Note 1 to our Readers: With the assistance of Nicole Lazarus and Santa Fe’s talented webmaster, Kyle Langan (studiox.com), we are in the process of revamping our website The new website, which will be launched by the end of February, includes important updates to chapters of our book, breaking healthcare news, and much more. Please take a look next month and consider recommending the website to relatives and friends – www.qualityaffordablehealthcare.net.
Note 2 to our Readers: Please share with us your experiences obtaining high cost medication and ask us questions; the answers may help other that follow our website.
Reminder: Always check with your doctor or P.C.P. before following any suggestions on our website. Our advice provides general ideas of navigating our complex healthcare system but does not give specific recommendations for your medical care.
Wishing you the best of health, Larry and Jeff