Posted on July 27, 2022 by Austin Lang
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If you’re one of the lucky few who doesn’t need prescription medication, congratulations. For the rest of us, regular trips to the pharmacy are an unfortunate, not to mention expensive, fact of life. Medication is one of the most common health care expenses people face, which is compounded by the fact that Original Medicare just doesn’t offer coverage for prescription drugs. How can you save money on prescriptions in the face of rising drug prices and rampant inflation? Well, we’ve got a few tips that can help you protect your health and your wallet.
Medicare prescription drug plans are the simplest way to save on medication costs. You see, prescription drug prices are determined by a complex series of negotiations between drug manufacturers, insurance companies, and the pharmacy benefit managers that serve as the middlemen between them. Unfortunately, this system can lead to some absurd prices for people trying to pay out of pocket. Like it or not, Medicare drug plans are the most straightforward solution, and they don’t need to be expensive.
If you’re looking to enroll in Medicare Part D, check if you’re eligible for Extra Help. This is a program that helps cover your Part D expenses and can make prescription drugs more affordable. You can also look into a Medicare Advantage plan that offers prescription drug benefits. Many Medicare Advantage plans have a $0 premium, and you might also qualify for a Special Needs Plan if you have a condition that requires regular medication, such as diabetes, heart disease, or even depression.
Before choosing any Medicare drug plan, be sure to confirm that any medications you take are actually covered!
All insurance plans that cover prescription medications have something called a formulary: a list of pre-approved medications that the plan will pay for. Formularies have tiers of coverage, with some medications being more expensive than others. These tiers are based on things like the price of the drug, but also on the aforementioned complex series of negotiations. Try to find a plan that covers your medications at the lowest tier possible to avoid costly copayments.
Many medications come in a generic formulation, which is much less expensive than their name-brand counterparts. For many common medications, going generic is a good way to save significant money. However, you still need to be cautious; some generic medications, particularly those produced overseas, may not be 100 percent identical to their name-brand counterparts. Consult with your doctor before switching to a generic formulation.
Where you pick up your drugs is just as important as who you choose for coverage. For instance, let’s say you need to pick up a prescription for fluoxetine, otherwise known as Prozac. You might be tempted to go to your closest corner pharmacy, but is that really the best choice?
According to GoodRX, which aggregates drug prices at many major pharmacies, you may find that the retail price of 20 mg of fluoxetine at your closest corner pharmacy is approximately $27 for a thirty-day supply. However, if you dig a little deeper, you may find that taking that same prescription to the pharmacy downtown means you’ll only pay $4. Be sure to fully research pricing options when choosing your go-to pharmacy
Did you know you can buy your prescriptions in bulk ahead of time rather than refilling as needed? It’s true! Ask your doctor for a 90-day supply. Buying your medication in bulk can save you a significant amount of money compared to buying it monthly, and it can save you trips to the pharmacy as well.
We recently covered Mark Cuban’s CostPlus Drug Company, which bypasses insurance entirely and sells medication directly to the consumer. This means that you don’t need to deal with the arcane rules that govern drug pricing and can just buy what you need. This does mean paying out of pocket, however, which means Medicare and Medicaid can’t help you save further. Still, it can be a good choice for those who only need certain medications and don’t want to pay for a full prescription drug plan.
We mentioned GoodRX earlier, but there are many other programs, both free and subscription-based, that offer discounts on drugs. In fact, you might already be a member of one. Amazon Prime offers a prescription drug discount program that can be used at many major pharmacies.
If there is one thing drug manufacturers hate, it’s bad optics. You see, in the complex series of negotiations between insurers, manufacturers, and pharmacy benefit managers, no one wants to be seen as responsible for rising drug prices. It’s not a good look.
Drug manufacturers come under particularly intense scrutiny for this, since suppliers set the initial price in most industries. So, in order to combat these bad optics, many manufacturers offer assistance programs for people otherwise unable to afford their medications. You may be able to purchase drugs directly at a lower cost, or you might receive massive discounts compared to the retail price. It’s another oddity of the often obtuse healthcare system, but it’s one you should definitely take advantage of if you can.
If you’re looking to save on your health care costs, we can help. Call a MedicareInsurance.com licensed insurance agent at (800) 950-0608 or enter your zip code to begin comparing plans today!
Austin Lang
Austin is dedicated to breaking down complex topics, like Medicare, in a way that's easy to understand. He graduated with an M.A. from Florida Atlantic University in 2018.