Whether or not you have insurance coverage, the cost of prescription medication can be exorbitant. According to Dr. David Yashar, a pharmacist practicing for over 18 years and owner of ACE Medical Pharmacy in Beverly Hills, “I have seen many patients through the years decide between picking up their prescriptions or having enough money to buy food.” “But times are changing,” according to Dr. Yashar. “Now we are fortunate that there are many more ways to save money on medication.”
With the help of a host of new non-profits, apps, discount programs, coupons and more, we can find significant deals that can save hundreds–if not thousands–of dollars a year. But where can we find all of these ways to save? The physicians at DoctorCPR decided to find out. We interviewed doctors, pharmacists, and patients. We met with insurance agents and pharmaceutical representatives…and we asked a lot of questions. In this article, the DoctorCPR.com Physicians Group outlines the top ways for us to save a lot of money on our medication.
1. $4 Dollar Generics
Generic programs are terrific ways to save money on medication. Did you know that you can get a 30-day supply of hundreds of medications from Ralphs pharmacy for $4 WITHOUT INSURANCE? Find out which grocery stores or pharmacies near your home have cheap generic programs. Many of these programs offer a 30-day supply of hundreds of generics for around $4 and a 90-day for around $10 even without using your insurance. A few of these programs do require a nominal annual membership fee. Check out the generic programs at Albertsons, Ralphs, CVS,Target (whose pharmacy is planning to become CVS), Walmart, Kroger, or whatever store is most convenient to you. Print or save the lists of medication covered for these generic programs and keep them with you when you visit the doctor. You can then tailor any new prescriptions to be covered under those programs as much as possible. Many of us will actually pay more for our generics if we go through our insurance rather than just using a $4 generic plan at our local grocery store. For example, Metformin sells for $10 for a 90-day supply at Walmart without using insurance, while a copay for just 30 days averages about $11.
2. Pharmacy Price-Comparison Apps with Coupons
Which local pharmacy will give you the best deal? The top two price shopping pharmacy apps (they are also websites) are www.Lowestmed.com and www.Goodrx.com. These apps allow you to quickly compare the cash prices of your medications at nearby pharmacies. Each app will apply a custom coupon discount to these cash prices. Many patients found lower prices on the Goodrx app more frequently, but they are both excellent apps. If you really need to find the rock bottom cash price, it is worth looking for your medication prices using both apps in case one is missing a pharmacy or offers better savings for a particular medication.
3. Copay Discount Programs
Simply put, if your prescription is paid in part or in whole by Medicare or Medicaid, you typically do not qualify for copay programs. If you have insurance and you really need to take a brand-name drug (can’t take generic), copay relief programs can save you hundreds–if not thousands–of dollars a year. For manufacturer copay coupons, you can often get these from your prescribing doctor or from an updated list on NeedyMeds.org. If you have insurance, but you still cannot afford your copays, you can apply for non-profit copay assistance such as Panfoundation.org. Typically your income must fall at or below 400 or 500% of the Federal Poverty Level, but that varies from program to program. If you don’t meet the criteria for Panfoundation’s copay program, there are many other programs listed on the Panfoundation site that offer excellent copay relief.
4. Prescription Discount Cards
If you have a high deductible, a high copay, or the need to fill a non-formulary drug, you should always consider medication savings cards. You can save hundreds of dollars (you can save over $300 dollars on one medication) and frequently, you pay a lot less by simply paying cash and using a prescription discount card rather than using your insurance. After comparing five different discount cards at three different pharmacies, we repeatedly found the most savings by using the GoodRx Prescription Discount Card. Can you still get the cash you pay for your medication to count towards your deductible if you use these cards? Yes. Simply keep track of your cash payments and submit receipts to your insurer to get credit toward your deductible.
5. Wholesale Clubs
Not only can Costco and Sam’s Club pharmacies fill your prescriptions, but they can fill them for bargain prices—even without a club membership. A recent report by Consumer Reports found that prices at Costco and Sam’s Club were among the lowest of all pharmacies when doing over 200 price investigations on commonly prescribed medications. There can be over a hundred dollar difference between prices from Costco versus your local chain pharmacy. However, you are still better off checking if your medication is covered by a free local $4 generic plan first before considering wholesale clubs. (Sam’s Club has a $4 generic plan, but you have to pay $100/year to access it).
6. Mail Order Pharmacies
The two most popular and largest mail order pharmacies are Express Scripts and CVS Caremark. Check with your insurance company or local pharmacy to find out if either mail-order pharmacy is included under your health plan. Most mail order pharmacies will offer you a lower co-pay on medication than you would pay in-store (but you will often need to get a 90-day supply). There are two main downsides to using these pharmacies: 1) There may be up to a two week delay in getting your medication and 2) They typically don’t accept co-pay discount cards from drug manufacturers. There are two other excellent mail order pharmacies with hard-to-beat discounts: According to a recent Consumer Reports Study, www.healthwarehouse.com, a certified online mail order pharmacy, provided the best deals (even better than Costco) on frequently prescribed medications when comparing close to 200 pharmacies. If you have financial hardship, we recommend visiting www.Rxoutreach.org. If you qualify, Rxoutreach has over 300 medications listed on their website for which they offer significant discounts. Many of the medications are $20 for a 180-day supply and are conveniently mailed to your home.
7. Pill Splitting
Check with your doctor to see if you can take a “half a tablet” of a double dose of your medication. This can save you a lot of money. For example, in many cases, a one month supply of a 30 mg tablet will cost the same amount as a one month supply of a 15 mg tablet. This typically doesn’t apply to time-release or coated capsules. According to the Federal Drug Administration, you should check the “How Supplied” section of the package insert of your medication or online prescribing information to see if your pills are suitable for splitting. In addition, you should split pills only as you need them (rather then split the entire supply in advance), and use an official “pill-splitter” (typically around $5-10).
8. Patient Assitance Programs (PAPs)
If you are uninsured or underinsured, you may qualify for patient assistance programs by pharmaceutical manufacturers. Your best bet is to either Google the company that makes your medication and “patient assistance program” or visit www.Needymeds.org where you can look up available patient assistance programs by medication name. You just fill out a quick and easy form, have your doctor sign it, and many programs will send six months to a year of medication free of charge if you meet their income requirements. If you are still unable to find a patient assistance program for your medication, you can call the drug manufacturer’s customer support line or visit RxAssist or the Partnership for Prescription Assistance–two other excellent websites to find the latest patient assistance programs.
9. State and Federal Help
If you have to take a medication that is not on your plan’s formulary and you are faced with paying the full cost, file an appeal with your insurer. If your health plan rejects your appeal, contact your state insurance regulator who will help you get your medication approved. Medicare beneficiaries with a limited income may qualify for Extra Help, a government program that helps seniors with costs of a Medicare prescription-drug plan, including monthly premiums, annual deductibles, and prescription co-payments. Extra Help is worth roughly $4,000 per year. If you have Medicaid, you automatically qualify for it. You can also check out pharmaceutical assistance programs provided by your state to help low-income seniors with Medicare Part D coverage. Another way to reduce costs if you are uninsured or underinsured is to go to a pharmacy that participates in the 340B Drug Discount Program. This federal program requires drug manufacturers to provide outpatient drugs to eligible healthcare facilities at significantly reduced prices. If you have to pay for medication out-of-pocket, you can save up to half of the cost of your medications at these contracted facilities.
10. Open-Enrollment Strategies
Whether you are shopping for Medicare plans or private insurance plans, it is important to be proactive about researching which plan will be the most cost effective based on your active medication list during open enrollment periods. If you are a Medicare patient who takes a lot of medications, it pays to be smart and to shop for Part D coverage using the Medicare website’s plan comparison tool. Go to www.medicare.gov and enter all of the medications that you take on a monthly basis. The site will then match you with the plan that offers you the best coverage for your medications. If you are shopping for private insurance plans and you are on multiple medications, check out the website Fingertip Formulary or the useful app Formulary Search to find out which plan formulary has the best coverage for your medications. Then you can compare the details about the drug copays and deductibles for the plans you are considering.
The U.S. has some of the highest prescription drug prices and spending in the world (For example, Americans spent $374 billion on medication in 2014). For all of us healthcare consumers, we must never become “victims of the system” and blindly dole out tens of thousands of dollars on medication without doing our research. Bankruptcy is not an option. We will continue to update our list of top secrets for saving money on prescription medication. All of us at DoctorCPR.com continually strive to empower healthcare providers and patients by providing practical tips to make medical careers and healthcare better for all of us. If you have a useful drug savings tip, we welcome your comments and links at the end of this article.