Updated: Jun 15, 2018
Are you finding your medical bills prohibitively high because of Rx costs? People living with chronic conditions like asthma or diabetes sometimes find it hard to access prescriptions drugs because of high costs. There are a few options that can bring down your prescription drugs cost. Sometimes it pays to not play by the rules. Most people that have health insurance just assume that when it comes to buying their medications their insurance company has behind the scenes worked out the best possible price. This isn't always the case. In several cases I have had customers that pay a copay for their Rx that is higher than even the regular cash price. Unfortunately for the consumer, in many cases if you don't ask, the pharmacy is going to charge you your insurance copay, regardless of the cost of the drug. Always ask if the cash cost for the med is better compared to the insured price. Here's more tips to help you save on your next trip to the pharmacy.
See if there's a generic, or an over-the-counter equivalent. Generics can cost a small fraction of brands. Guidelines govern when a brand name may be manufactured and sold as a generic; this may change the status of your current meds, as well as its cost, quickly. Many prescribed allergy meds lately have now been converted to over-the-counter drugs. Why pay for a Rx if you can pick it up in the aisle?
Try the MedCard Incare Rx discount card. Incare and the participating pharmacy have arrangements that work out a discounted price on most medications. Ask your pharmacy what the purchase price is 1) with your insurance coverage, 2) using the CompMed Rx Card -- and 3) the cash price. Every medication is different and in some cases the discount card may be higher than the cash price. It's important to check each of your medications.
Discount Coupons & Warehouses. There are drugs coupons online on drugs price comparison sites like lowestmed.com, goodrx.com, and blinkhealth.com. There are also low-cost online pharmacies like healthwarehouse.com. But when buying online, it is important to ensure that the business is a Verified Internet Pharmacy Practice Site. Try out BlinkHealth.com. Blink negotiates with pharmacies on an agreed cost. Then you buy your medication through their program, and go directly to the pharmacy to get it. Blink has a cut they get with the purchase.
Apply for a Patient Assistance Programs. These are programs run by state governments, charities and pharmaceutical companies. For PAPs run by drug companies, you apply to be put on the program. The drug company has qualification criteria that are based on need and capability to pay. Most brand name drug manufactures have a program for lower income customers to receive their medications at little or no cost. Visit your drug manufactures website and search for "PAP". Help programs for patients in need are often not used if healthcare providers and patients don't realize these programs exist or do not know the enrollment procedure. Consequently, it is necessary for doctors as well as other medical care professionals to become aware of the opportunities provided by these programs. MedCard offers a PAP (Pharmaceutical Assistance Program) help benefit at no extra cost to members with the hope of increasing awareness among professionals, brokers and patients. Simply review the qualifications for your medications PAP program and then submit your information on a simple short form to MedCard. Within 72 hours members receive an email with the correct application and step by step instructions on completing the application.
State-run PAPs target chronic conditions like HOV/AIDS and kidney ailment. These are usually for disabled, elderly and needy people. State PAPs are usually done in conjunction with Medicare to offer fuller services.
There are a number of charitable NGOs that ran PAPs as well. These include:
• Rx Hope
Patient Assistance Programs usually work with tie-in Rx cards. This is a card that is loaded with credit provided by the entity giving the assistance. These cards are also popularly known as co-pay cards because you pay part of the money.
NeedyMeds.org specializes in finding savings programs on medicines and healthcare. Their listing started fairly tiny but has exploded significantly. They currently list over 1,600 discount coupons, rebates and other offers. As mentioned earlier some of the best help you can get on a prescription is with a manufacture PAP. These programs usually are offered by pharmaceutical companies as well as other companies to help you get your medications for a few dollars to no cost. Many individuals, however, are not eligible for these programs because their earnings are too much or they are insured. Once they understood this they started to gather info on discount coupons, rebates and other programs. So if you don't qualify for a PAP program you'll want to check them out. Listings are posted by brand of medication, including both over-the-counter and prescription drugs. The offers vary and can include printable coupons and rebates, cost savings cards, 7-30 day free trial offers, and free samples of your medication. Most offers are available to both the insured, under-insured and uninsured.
Generic drugs use the same formula used in big-brand names but come at a fraction of the cost. You can ask your doctor to make a prescription for generic drugs. There is also therapeutic substitution which is switching to different drugs that deliver the same results.
Non-drug therapy. Sometimes non-drug therapy will work just as well. Migraines, for example, come on from certain triggers. If you figure out these triggers you can avoid them. Some of the effective non-drug therapies include Cognitive Behavior Therapy, physiotherapy, dieting and physical exercises.
Switch your insurance provider. It is important to compare different health insurance plans because coverage changes from year to year. Choose a health plan that covers the drugs you need at an affordable rate. Typically, high-deductible plans will require you to pay more for the drugs. Talk to a local health insurance agent to see what options are available in your state.
This last one needs to be researched carefully and isn't a recommendation but because it's common I'm listing it...buying meds from Canada. It's no secret that our neighbors to the north enjoy "VIP" pricing when it comes to Rx drugs. If you’re contemplating this, you need to know that there is no agency protecting your purchase and insuring that you're getting the real deal. It's also likely that your purchase isn't 100% legal. With that said there are numerous organizations that operate in the states and purchases drugs in Canada for their clients in the US. If you do decide to do this it's very important that you make sure you're dealing with a legitimate company that is not out to just take your hard earned money. If you have friends or relatives that have done this I would make sure to only use sources that they have used and that they were happy with the results.
Part D Patients
There have been plenty of discussions regarding Medicare Part D donut holes and the sometimes limited formulary list these plans have. Hundreds of thousands of Indiana patients cannot afford their prescriptions and are in need of prescription discounts and programs that provide Rx help at little or no cost. Meanwhile, costs associated with prescription drugs along with the amount of underinsured clients tend to be rapidly increasing. Fortunately many pharmaceutical businesses provide support programs for customers who require medicines but have inadequate income to buy them. Pharmaceutical companies' medication Rx help programs can be used to enhance the medication usage of those who are in need. Roughly 53% of the top 200 medications in 2000 had been provided through support programs to patients that are indigent.
Customers with limited earnings, like many of the elderly, may have greater trouble purchasing their prescriptions compared to the general population. Many times these same patients are not very internet savvy and may not be aware of the very programs designed to help them. Often times they may also lack the ability to properly complete the assistance application and supporting documentation. For these reasons regularly these customers go without needed medications, thus enhancing the dangers of untreated conditions and the consequences.
Qualifying For Rx Assistance
Rx assistance programs have differing qualifications and requirements for enrollment. Some common qualifications include having limited or no prescription coverage, earnings and asset restrictions and ineligibility for Medicaid or VA benefits. Income limitations typically require your household income be below 300% of the federal poverty line. For 2018 an individual is 300% below FPL if their income is under $36,180 a year. Many companies require verification of financial standing by requesting financial documents including tax returns, W-2 forms, bank statements, mutual fund and stock statements, as well as other asset reports. Once documents are received they are evaluated to determine the individuals need. Once approved the manufacture will typically send your medication to your home or doctor's office (depending on program requirements) every 90 days. You're all done for now, but keep an eye out for any mail asking for annual re-certification. These letters will typically request a recent pay-stub or tax return to make sure you're still within the income guidelines for your program.
Try out some of the ideas above and let us know what you think. If you're not currently a MedCard member consider becoming one. Not only do members have access to our discount prescription card and PAP help, they enjoy access to 24/7 doctor consultations, Medical Bill Saver and more.