As a family medicine Physician Assistant, one of my constant struggles is finding affordable medications for my patients. Sometimes this feels like an impossible task and I can only imagine how frustrating it must be for patients. This post is primarily for people with commercial insurance or no insurance. Medicare and Medicaid are a whole different ballgame and many of the below suggestions will not apply to these policies.
First things first, I am not affiliated with ANY of the below mentioned products or businesses. This post is in no way meant to address the ethical and political issues surrounding insurance and pharmaceutical companies. There is a lot of unrest surrounding these topics in our country and I am not about insert myself in the middle of that battle. I am also not suggesting that you take or not take any medications other than what your healthcare provider has recommended. I am simply trying to offer assistance in an area of budgeting that has become dire for some people. The cost of necessary prescription medications can be crippling and there may be a way around that for you. Let’s get to it.
I cannot tell you how many times I have been told AFTERWARD that a patient paid $75 for a generic prescription! Telling us after you pay is too late. I know that it is frustrating to get to the pharmacy, wait for your prescription, and then find out it is too expensive and have to start all over again. If you have been to that pharmacy before, they will be able to give you the price of your prescription over the phone so that you don’t have to wait in the store during this process. Usually, providers have a good idea of which medications are inexpensive, but remember that there are a million different insurance policies with their own nuances, drug plans, deductibles, and fine print and we do not have them all memorized. Also, sometimes there is a drug shortage or a re-patent of a medication that we haven’t yet heard about. It’s not like those companies send us a quick email letting us know that a previously cheap medication now costs a holy fortune (although that would be so helpful). If you get to the pharmacy, and the prescription price seems insane, ask the pharmacist to give us a call and we can usually work together to find a cheaper alternative for your plan.
Saving on Generic Medications
Walmart $4 list and Target $4 list: These lists includes a wide variety of common, generic medications. Typically, a 30 day supply is $4 and a 90 day supply is $10. These lists change occasionally, but most providers are relatively familiar with them. If you are taking generic medications for common problems such as high blood pressure, elevated cholesterol, or if you need an antibiotic, there is likely to be a good option for you here.
Walgreens Value-Priced Medications: Walgreens values medications based on a “tier” classification. Each tier is a different price. CVS has a similar program.
Harris Teeter Generic Prescription Savings Club: This program has a $4.95 annual enrollment fee with your VIC card. Again, there is a long list of generics for $3.99/month or $9.99/3 months. There is also a list of FREE antibiotics with this program for problems such as skin infections, upper respiratory infections, and urinary tract infections. This list includes child’s doses of Amoxicillin for those of you who have babies with constant ear infections or strep throat. Type 2 Diabetics can get Metformin and a couple other generic diabetes medications for free with this program.
Sam’s Club Extra Value Drug List: Non-plus members have access to discounted drug prices. Plus members can get some prescriptions free and others for $4 or $10.
Saving on Brand Name Medications
Co-pay cards: Most newer medications have co-pay cards available. If your provider’s office does not have a co-pay card for you to try, look for the medication’s website online. There will usually be a link to a savings card. I will use the EpiPen for example because of all the hullabaloo in the news lately. Depending on the details of your commercial insurance policy, you can save up to $300 on this prescription. There will always be caveats with these cards and various insurance policies but it is absolutely worth a try. Exciting side note: often the “money saved” with these co-pay cards still goes toward your deductible.
Drug Assistance Programs: If you require a brand name drug and you do not have insurance, several pharmaceutical companies offer assistance programs for which you can apply. There is usually a maximum income associated with these programs, but they can be a huge help if you qualify. Again, these programs can be found online, but they usually require a portion of the form to be completed by your healthcare provider.
Local Assistance Programs: Some communities have local drug assistance programs and free clinics. Talk to your pharmacist or provider about this option.
Health Savings Account/Flexible Spending Account: Many employers offer these accounts as a benefit. These programs allow you to use pre-tax money for medical expenses like co-pays, deductibles, prescriptions, etc. Always, always, always take the opportunity to spend pre-tax money. Your discount is the tax break on that amount of money. This could be anywhere from 10-39.6% off depending on your tax bracket.
Some medications cost a fortune and there is just no way around it for whatever reason. If that is your situation, I am truly sorry because it is so frustrating and unfair. For the majority of medications, there is a cheaper alternative or an opportunity to save. I hope you can find some helpful tips here to keep your budget in tact while still doing what is best for your health.