Read these 16 Health Insurance And Prescriptions Tips tips to make your life smarter, better, faster and wiser. Each tip is approved by our Editors and created by expert writers so great we call them Gurus. LifeTips is the place to go when you need to know about Health Insurance tips and hundreds of other topics.
Federal and state governments are constantly coming up with new programs to help pay for prescription drugs, so it is important to check into your state's program every few months. You can find more information about some of these programs by going to the Centers for Medicare and Medicaid, http://cms.hhs.gov/medicaid/; NeedyMeds, www.needymeds.com; RxHope, www.rxhope.com/pap_info.asp and RxAssist, www.rxassist.org, or www.ncsl.org/programs/health/drugaid.htm. Some states have multiple programs and others do not have the funds to advertise their programs, so it may take a little research. You can also contact you local state health representative to see what programs may not be listed.
Drug companies are always giving away samples to physicians, so your doctor may be able to supply you with several weeks' worth of medication at no charge. Not only is this free, but if you find that the medication is not working, such as a cream for a rash, you won't be left with an expensive tube of cream you can't use
Some doctors have great relationships with certain pharmaceutical companies and some pharmaceutical companies want better relationships with some doctors. If you have a positive relationship with your doctor, as him if he/she would not mind calling the pharmaceutical company of the drug he/she is prescribing and asking for a discount.
If you have no drug coverage, you might find discounts on you drugs through the Partnership for Prescription Assistance, www.pparx.org. This program has links to more than 400 patient-assistance programs offering discounts on more than 2,500 medications. Most programs require you to demonstrate financial need. But some offer discounts to all income levels. You may also try to receive a manufacturer's discount at www.together-rx.com or recommend that your doctor call the Pharmaceutical Manufacturers Association, www.phrma.org, 202.835.3400 and ask for a guide on some of these programs (patients themselves cannot request this information).
Call your drug insurer, or your pharmacy benefits manager (PBM), and ask if you can order your prescriptions directly from the plan. Typically you will save 15% to 35% on your monthly co-payments at the pharmacy, or nearly $90 a year on the average prescription.
The federal government doesn't regulate prices on drugs sold at pharmacies, so your costs can vary widely depending on where you buy. You may find that the pharmacy a few miles away may have one or two medications that are less expensive than the pharmacy across the street. Simply call the pharmacies in your area and compare prices. You may also want to ask if they have enough of the drug on hand to b dispensed so you do not run to the pharmacy only to find they have to ship it in from another store. The best prices are often found not only at discounters like Costco and Wal-Mart but also at drugstores that aren't part of a chain.
Going along with tip number 32, be sure you examine the prescription name and don't be afraid to ask the pharmacist if the prescription seems different than what the doctor said he was prescribing for you or what you are used to receiving. You don't want to be paying for a brand name drug when all you received in the generic.
Be sure your pharmacist dispenses the correct number of pills. You might find a few missing when you receive your prescription. For example, you might find an 80 day supply instead of 90 and you paid for a 90 day supply. Don't be afraid to ask why and ask for a refund for the pills you did not receive. If you are dissatisfied with the answer, don't be afraid to go to another pharmacy. There are plenty out there who will give you what you paid for.
This strategy will not work for all medications, but it tends to work for many of the world's best-selling drugs. In most cases, high-dose pills are generally priced the same as their low-dose counterparts, so ask your doctor if you can safely split a higher-dosage pill in half. You should save at least $160 a year or more per prescription if you don't have drug coverage or 50% on your co-pays if you do.
Whenever you can, opt for generic drugs. According to the National Association of Chain Drug Stores the average cost is less than a third as much as their brand-name counterparts. For example, the drug mentioned in tip number 29, Zegerid, can cost over $4/pill as opposed to its generic form, Omeprazole, which can cost as low as .17 cents/pill; however, the generic equivalent may not be as effective as the branded OTC drug because it may have other fillers.
Remind your prescribing physician that you are interested in generic drugs if that is an option. This way, he can take that into consideration and avoid writing DAW (Draw As Dispensed), and have your pharmacist assist you with the generic equivalent.
You might still need to comparison shop to get the best price on generic drugs these days. Unfortunately, some major pharmacies do not pass on the discounts that they got on these generics to their customers.
Don't forget about over-the-counter medications: By sticking to the no-name store brand, you'll save $100 of the $400 that the average American spends annually on over-the-counter drugs; however, many of these may not have started out as prescriptions.
On the other hand, the prescription drug, Zegrid, which may have cost of $4/pill, may be found Over the Counter (OTC), under the “branded name” Prilosec, for about .68 cents/pill, and it is exactly the same thing as the prescription at a lower dosage.
Do not overlook the additional coverage needed to fill you medications. Not all health insurance policies include your pharmaceuticals. The deductible you pay for pharmaceuticals may have nothing to do with the cumulative inpatient or outpatient care deductible. Be weary of low drug deductibles because they may reflect in you entire health insurance premium.
Also, make sure to inquire about the dug list or “formulary.” Often times these lists are not made available to the public. Compare this list to the drugs you are currently using, or drugs you may need in the future, such as antibiotics that you know work best for you when you are sick. If you find that your prescription is not listed, ask the insurer if exceptions are made for the drugs you do not see listed as well as the process of getting that drug approved and how much time it should take to get approval.
Some insurance plans have a "cap," which may be the most you will have to pay for medical bills in any one year. You reach the cap when your out-of-pocket expenses (for your deductible and your coinsurance) total a certain amount. It may be as low as $1,000 or as high as $10,000. Then the insurance company pays the full amount in excess of the cap for the items your policy says it will cover, but there are limits. The cap doesn't include what you pay for your monthly premium. It may also have a cap or limit on medical tests, number of doctors visits, preventative coverage and other services. Inquire as to what types of healthcare the cap will cover. For example, some policies will pay no more that $550 a day for hospital care and for a certain amount of days. Some insurance will impose a “lifetime maximum cap” which is the amount after which the insurance company won't pay anymore. This is important to know if you or someone in your family has an illness that requires expensive treatments.
|Jennifer Mathes, Ph.D.|