Healthcare Business DEMYSTIFIED

de mys ti fy - to make less mysterious, clarify

What can I do to lower my prescription costs?

Many of the health insurance plans offered by employers have a prescription drug component included in the product.  This is true of most of the plans you can buy on the open market as well.  The Medicare Advantage plans, for the most part, include the prescription drug option while the Medicare plans require the additional Part D coverage to be purchased separately.  In order to control costs and save money, the insurance plans have put together a list of preferred drugs that is called a formulary.  You should be able to get a copy of the formulary so that you can see if your current prescriptions are included.  These formularies are often arranged in a tier system.  As you progress through the tiers, the price of the prescription increases.  It is in your best interest to study the formulary and try to choose medications from the cheapest tier.  That way, you can keep your out of pocket costs to a minimum.  You may want to print out the formulary and take it to your doctor's office when you go for a visit.  Let your doctor know you are trying to keep your out of pocket costs down and ask her if there are any cheaper alternatives to your current medications.  They will be able to review the formulary and let you know if there are any medications that are available at a less expensive tier.  Ask to try the medication to see if it will work for you,

When you are ready to get your prescriptions filled, call around to your local pharmacies and compare prices.  You will be surprised to learn that they are not all charging the same amount.  It can pay to make a few calls as this can often save you money.  Your doctor's office may have some samples that you can try to see if a medication switch works for you.  They may also have coupons for prescription medications at their office.  Check the website of the pharmaceutical company that manufactures your prescription drug for additional offers.  Many pharmaceutical companies will offer coupons for their products.  You can also check websites like for all offers in one location.  This website also has over the counter medication coupons.

If you are having trouble paying for your medications, you may qualify for a patient assistance program (PAP).  Many pharmaceutical companies have programs like this to help patients that cannot afford their medications.  Ask the business office at your doctor's office about such programs.  They may be able to help you fill out the application or direct you to a local agency that can assist you.  Most companies require you to provide proof of your inability to pay.  This is usually a tax return or some other form of proof.  The application will list, in detail, what types of supporting documentation they will need.  Please see the Topic "What are my alternatives if I can't afford health insurance?" for more information.