America is a sick country. It is reported that around 70% of Americans are on at least one prescription drug and around half of the country is at least on two. That’s a lot of pills for a lot of people. Seeing patients on a regular basis myself, I can definitely confirm this. I see multiple patients every day who are on a whole cocktail of medications. Now this is a huge problem in itself, but it is also a huge financial problem for the patient. Medications can get expensive, especially if you have to take a lot of them. So I’ve compiled a few ways that I think can really change the game when it comes to paying for meds:
Ask for a generic medication- This should be the first thing you ask your doctor. Doctors may give you a brand name medication because of incentives from a company or just because they are used to writing it. It never hurts to ask for a generic as long as it will get the job done as well as the brand name drug. And there can be huge cost savings. There certainly are cases where a brand name medication may work better than a generic, but it definitely pays to ask. And don’t think that if a brand name is covered by your insurance that you won’t pay much. In my experience, it is actually cheaper to pay for a generic out of pocket than a brand name that is covered. Always ask your doctor if there is an appropriate generic medication you can take for your condition.
Shop around- Many people are unfortunately unaware that you will pay different prices at different pharmacies for the same medication. Simply calling around to different pharmacies to see how much your medication will cost can save you lots of money. Some pharmacies even have special low prices for certain commonly prescribed medications. Generally, warehouse stores such as Costco and Sam’s Club have much better prices than other pharmacies. It is definitely worth it to call or visit different pharmacies in your area to get the best price. A website that can help is called goodrx.com. Just type in your medication and zip code and it will show you which location in your area will have it for less. It can be surprising to see the price disparity between different stores.
I prescribe medications on a regular basis, and when patients come back for their follow up exams I always ask how much they paid. I’ve gotten wildly different answers for the same medication, even with insurance coverage! It really is worth your time to call around to your surrounding pharmacies and get the exact price.
Consult the drug formulary- To add more confusion to the health insurance maze, not all insurances cover all medications the same way. It actually varies very widely so it pays to check the formulary, which is the list of medications that your insurance will cover. Insurance might cover medication A for a disease, but not medication B. You should check with your doctor to see if they can preferably prescribe a drug which is already on the formulary. Being prescribed a non-formulary drug and getting sticker shock at the pharmacy is no fun.
Ask the doc for samples- Doctors get bombarded by drug reps who want them to prescribe their companies’ medication. They sometimes give doctors samples of their medication. If the doctor tells you a brand name medication is necessary, be sure to ask for any samples they may have. That will at least give you a few days supply so you can shop around at different pharmacies.
Ask for coupons- Similar to the last point, drug reps sometimes leave coupons for certain medications. Some websites (such as needymeds.org) also have coupons for various medications. Many drug companies have reduced cost programs for certain drugs. It never hurts to ask if something like this exists.
Get a second opinion- There can sometimes be more than one way to treat a condition. Certain levels of high blood pressure, for example, can be treated with a medication or simply with diet and exercise. When you get a potentially serious diagnosis and the doctor insists on one way of doing things, it might be worth it to get a second opinion. You can ask family and friends for any trusted doctors in the area and see if there may be an alternative. In the aforementioned example, controlling blood pressure with diet and exercise may be all that is needed, which can lead to better health overall and definitely some money saved. Some doctors may be quick to pull the trigger on prescribing medications, so that could be the right time to seek another opinion.
Use an FSA account- Many workplaces offer flex spending accounts to their employees. What these accounts do is set aside a portion of your pay for the year, decided by you, and give you a debit card with that amount that can be used on certain medical related expenses. It can be a game to see what exactly is eligible, but FSA money is definitely eligible to be spent on medication. The main advantage of an FSA is that the money you have set aside is not calculated as part of your income. So instead of using money that has already been taxed, you can use pre-tax money to pay for medication. Even if you do not go to the doctor much, FSA money can be used for other things like dental work or glasses and contact lenses.
Open a Health Savings Account (HSA)- HSA’s are great for many reasons. And they’re definitely useful for their intended reason: helping you with your healthcare expenses. Paired with a high deductible health account, which aren’t the best choice for everybody, the HSA is a great companion. It lets you set aside money before taxes, allows them to grow tax free and then be withdrawn tax free as well. I wrote about how you can use it as kind of a pseudo-IRA here. When it comes to your health care costs, it is a powerful tool as well. If you can handle small costs like doctor co-pays and medications out of pocket on your own, you can allow your HSA to grow and use it for big planned (or unplanned) expenses like LASIK or any other surgeries. As I mentioned before the high deductible plan may not be for everyone but if you decide to go with one, you should definitely sign up for an HSA.
As the famous saying goes, prevention is always better than cure. Practicing healthy habits such as staying active every day and eating right will lessen the chance of needing certain medications. Most people need the occasional antibiotic, but conditions such as high blood pressure and diabetes are preventable for the most part. These chronic diseases can be debilitating to your well-being and also your wallet. Your health can be looked at as an asset, just like any bank account you may have. If you don’t take care of it, you will definitely be paying for it. Hopefully some of these tips will help ease the financial burden.
The only medication I take daily is birth control and I always ask for generic.
Good tips here. I always buy generic when something is prescribed for me. I also have a HSA now that I have a high deductible health plan (not by choice).
It never hurts to ask your doc for a generic. Most of the time they work just as well as brand name medications. Sorry you were forced into a HDHP but at least you get to use the HSA.