Can I Afford My Medication?

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.

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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.

What To Do About The High Cost Of Prescription Drugs

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 a strain on your wallet. You should explain to your doctor that you cannot afford the medication. How will he/she know you cannot afford your medication if you don’t tell them? Your doctor will most likely have options available to prescribe something much 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. You will find different pharmacies can charge different prices too.

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. Your health insurance agent is another great resource for information. Please do not hesitate to call.

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. 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. Some websites like have substantial discounts. 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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Let Nevada Insurance Enrollment Help

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.

Related Articles:

What Is A Prescription Drug Deductible?

What Is A Health Insurance Prescription Drug Formulary?

The Connection Between Prescription Drug Prices and Health Insurance Premiums

Prescription Discount Card vs. Prescription Insurance


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