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’re among the 55 percent of Americans that is 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 continues 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 that they’re not taking the medication that they were 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 can’t work with you to find options that won’t place such a strain on your wallet.
If you’ve been prescribed a new medication and you’re wondering how much it’s going to cost you, then give your pharmacy a call prior to submitting the script. If it’s a pharmacy that you’ve used before and they already have your insurance information on hand, then they should be able to easily tell you 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.
Find Out 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.
So how does it work? Well, 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 simply charge you your copay. You assume that your modest copay is cheaper than the cost of the medication, and you pay it without questioning. What you don’t know, however, is that if you’d 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 is usually about four dollars.
Simply asking your pharmacist what it would cost you to pay for the drug out-of-pocket can save you money. Just know that the money you pay out of your pocket will not obviously count towards your “Out of Pocket Maximum”. Prescriptions that are run through your insurance ALL count towards your “out of pocket maximum”.
As the cost of prescription drugs continues to climb, it’s important to educate yourself and keep your doctor in the loop to ensure that you receive a treatment plan that will work for you. Your health insurance agent can also help you review your coverage and make sure that it is a good fit, even as your needs change.