The typical American spends $1,200 on prescriptions annually. Here, expert tips to slash your bill without sacrificing the care you deserve.
You know to ask about less expensive generic alternatives, but you may be surprised that you can often save by checking the form of your prescription, reveals expert Frank Lalli, former editor of Money magazine, author of Your Best Health Care Now, and health correspondent for NPR’s Robin Hood Radio. “The list of drugs, or formulary, covered by insurance may only apply to the tablet of a certain medicine and not the capsule, or vice versa,” he says. “The tablet may be $8, say, while the capsule of the same drug costs $83. Just ask, ‘Why this specific form of the drug?’” If there’s a cheaper version with the same benefit, ask your doctor to prescribe it.
When he was prescribed a drug that cost $12,000 per month, Lalli cut that figure in half. “There’s a practice called ‘flat dosage’-for example, 80 mg. and 40 mg. of the same drug may both cost $40.” If your doctor recommends the lower dose, Lalli suggests asking her if she would prescribe the higher dose so you could cut it in half.
Score a price match.
There can be a big difference between prices even within the same pharmacy chain, reveals Lalli. “Call a couple of pharmacies and ask what the drug costs with your insurance,” he says, recalling the story of a man who was paying $140 and $10 for medications at Walgreens, while at a nearby Walgreens, they cost $30 and $4. “Ask the pharmacy to match the price-they’ll often say yes.” Also smart: Ask the pharmacist if you can save by paying out of pocket, says expert Elisabeth Rosenthal, M.D., editor-in-chief of Kaiser Health News, an independent newsroom focusing on health, trained at Harvard Medical School. The copay for a generic drug may cost you $20 while the medication itself only costs $10.
Dodge the refill oops.
Big chains, like Kroger and Publix, have a “deep discount list” of generic drugs that cost as little as $4, which people often put on auto refill. The hitch? “These discounts only cover a specific dosage,” explains Lalli. “Say the price applies to 20 mg. — if you’re prescribed 25 mg., that $4 drug may now cost $100.” Stores periodically change their list. Call the pharmacy to make sure your drug is still discounted.
Try an ‘exception’.
If you enrolled in a Medicare plan only to learn that a drug you’re taking isn’t on the formulary, ask your doctor to help you file an “exception” requesting it be covered, advises expert Danielle Roberts, author of 10 Costly Medicare Mistakes You Can’t Afford to Make, and co-founder of Boomer Benefits, an agency helping seniors navigate Medicare. “If they approve it, they’ll let you know which drug tier it falls into-it’s always worth trying.”
Tap ‘extra help’.
Folks on Medicare Part D may be eligible for a program called “Extra Help,” reveals Roberts. “Just go to the Social Security website to learn if you qualify,” she says. “So many people are skipping doses to save money and they don’t know about this program-it reduces copays significantly and can save you thousands of dollars per year.
This story originally appeared in our print magazine.