The cost of prescription drugs has never been higher. In fact, recent years have seen price increases of as much as 10 percent. If you are among the 55 percent of Americans that are taking a prescription drug, you may be concerned about the affordability of medication therapy. Fortunately, there are a couple of things that you can do to ease the financial burden.

Talk to Your Doctor

As the cost of prescription drugs continue to rise, more and more patients, even those with health insurance, are neglecting to fill their prescriptions. Oftentimes, people don’t tell their doctors that the cost of their prescription drugs is high on their list of concerns. Perhaps even more troubling is that many people don’t tell their doctor they’re not taking the medication that was prescribed. Rather than seeking out a less expensive alternative to a pricey prescription drug, too many patients opt out of the medication therapy that they need.

Unless your doctor knows that your ability to follow through with your treatment plan is contingent on the affordability of a medication, they won’t be able to find less expensive treatment options. You should explain to your doctor that you can’t afford the medication. How will he/she know you can’t afford your medication if you don’t tell them? Your doctor will most likely have options available to prescribe something less expensive for you. Speak up and advocate for yourself. Don’t be embarrassed, prescription drugs are expensive!

If you’ve been prescribed a new medication and you’re wondering how much it’s going to cost you, give your pharmacy a call prior to submitting the prescription. If it’s a pharmacy that you’ve used before and they already have your insurance information on hand, they will be able to inform you of what your out-of-pocket expense will be. If the cost of a prescription is prohibitively high, talk to your doctor about less expensive alternatives. Shop around! You will find that different pharmacies can sometimes charge significantly different prices.

Find the Out-of-Pocket Cost

While the cost of many medications is outrageously high, others are more affordable than you realize. If you have an insurance plan with a copay for medications, you may assume that using your insurance will get you the best price on your medication. However, according to health economist Karen Van Nuys, this isn’t always the case. A study conducted by the University of Southern California Schaeffer Center for Health Policy & Economics, uncovered that consumers overpaid for their prescription drugs 23 percent of the time. The average overpayment on each transaction amounted to $7.69. Brand-name drugs are associated with an overpayment amount of over $13. Your health insurance agent is another great resource for information. Please do not hesitate to call us.

Stop! Ask Questions Before You Pay

How does it all work? If you have a fixed copay (versus a copay that is a percentage of the cost of the medication) and you’re purchasing a prescription, the pharmacist will likely charge you your copay. Copays are great because they are not mystery charges and are a fixed amount. You assume that your modest copay is cheaper than the cost of the medication, and you pay it without questioning. In most cases this is true, but if you paid out-of-pocket, you may have actually paid less.

For example, say that you’re filling a prescription for amoxicillin, you could pay your $10 copay, or you could forego using your insurance and pay the out-of-pocket amount, which can be four dollars, depending on where you have the prescription filled. Be careful here however, because the money you actually pay if you don’t use your insurance will not count towards your out-of-pocket costs on your insurance plan. In other words, you won’t get credit towards your out-of-pocket costs if you don’t use your insurance to buy your medications.

Simply asking your pharmacist what it would cost you to pay for the drug out-of-pocket can save you money. Please note, once again, the money you pay without using your insurance will not count towards your “Out of Pocket Maximum” and prescriptions that are run through your insurance DO count towards your “out of pocket maximum”.

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Those who depend on prescription drugs have a couple of options that may make filling their prescriptions easier on their wallets. There are three options to receive discounts on prescription drugs.

1. Coverage included with your medical insurance plan
2. Prescription drug discount plan
3. Using coupons and phone apps

While each of these plans can help you save you money, the way they work is quite different.

Prescription Drug Insurance

Prescription drug insurance is most likely integrated into your health insurance plan. Your personal individual and/or family health insurance plan will have a monthly premium that is paid by you, or you may have an employer provided health plan with prescription drug coverage integrated into the employer plan. When you fill a prescription, you will most likely pay a flat-rate copay, or you could pay a “deductible” first, depending on your health plan and the cost of the drug. Then the insurance company is billed for the rest.

When helping you select the right prescription drug insurance plan, one of our health insurance agents may ask you what medications you’re currently prescribed. Different insurers have different drug formulary’s (a lists of covered drugs). These preferred drugs may be both brand name and generic drugs, and they are chosen for their cost, effectiveness, and safety. Non-formulary drugs are not covered by the insurer, and the member will pay the entire cost. By verifying that the medications you’re currently taking are on an insurer’s formulary, your agent can ensure that you receive the medication for the best price.

Prescription Drug Discount Plans

While prescription drugs are covered with your health insurance plan by insurance companies, prescription drug discount plans are often provided by drug stores, drug manufacturers and membership organizations. Some discount plans are available for a monthly or annual fee, while others are free. The way they work is like a coupon. When you fill a prescription, you provide the pharmacy with your card, and you’ll receive a certain percentage off the cost of the prescription. This discount may vary from one drug to another, and different discounts may be applied to generic drugs and name brand drugs.

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