The rising cost of the medications is a major concern for millions of Americans, who are finding it difficult in receiving proper healthcare treatment. Despite having health plans with prescription drug coverage, and prescription insurance assistance, people are suffering due to the cost-sharing burden. Due to this, people are not filling their prescriptions, which is leaving their illness and conditions going untreated. The rising cost of prescription drugs has left many Americans struggling to pay for their medications, and as per a Kaiser Family Foundation poll, one in four people said, they or their family members have cut pills, skipped doses, or failed to fill a prescription. This burden is bound to increase over time, as nine out of ten people age 65 or above need to take at least one prescription drug a month, as per the National Center for Health Statistics.
Fortunately, there are a few things that people can do to lower their drug costs without putting their health at risk.
Check Plan’s Formulary
There is a big difference in the manner in which health insurance plans cover the same medications. People need to take those differences into account during their open enrollment period, otherwise, they will need to pay more for the medications they take for the rest of the year. Thus, people need to focus on the plan’s formulary, or the list of drugs covered and should ensure that their medications are included in the plan’s formulary. If their drugs are included in the plan’s formulary, then they will be able to save the costs of the drugs, and if their drugs are not included in the formulary, then they will have to pay the drug cost from their pocket.
Out-of-pocket costs of Drugs
Most of the health plans group medications into three or more price tiers. For the drugs included in the higher tier, people will need to pay more out-of-pocket costs in either coinsurance or a flat copayment. Tier 1 drugs generally include generics drugs, whereas Tier 3 drugs include expensive branded drugs or specialty medications. The average co-pay for the tier-1 drug is $11, while the average co-pay for the tier-3 drug is $59, and the average co-insurance for tier-1 is 14%, whereas average co-insurance for tier-3 is 33%. The other out-of-pocket costs that may be included in the prescription drug cost is the deductible. Deductibles that have been common for doctor visits and hospital stays have now become relevant to prescription drug costs too. Today nearly four out of ten plans require people to meet a deductible before covering any of their prescription drug costs. Though medication deductible is included with a medical deductible, this is not always the case.
Research with the Doctor’s Office
Even if people choose a plan keeping their current medications in mind, there is a chance that their doctors orders a new drug. Though doctors often prescribe well-known generics drugs, however, studies tell that they are not aware of the costs of the medications that they are prescribing. To help people out, many insurance companies have come out with apps that help people know about the covered medications along with their cost. People should download the app onto their phone before visiting their doctor so that they can immediately check whether the medications prescribed by their doctor, are covered under their plan or not. If the prescribed medication is a costly tier-3 drug, or are not covered, then people can ask their doctor on the spot, if there are alternative drugs available with the same therapeutic effect at low cost or not. If this is not feasible, people can even talk to their pharmacists, who can call their doctor, and suggest an equivalent medication if the out-of-pocket costs of the drugs are high.
People need to Review their prescriptions
Time to time, people need to review their prescription, because there is a chance that they might be taking a medication, which they no longer need. For instance, people may have been prescribed a drug, and then a new drug was included because the first was not working. Then there is a chance that the first drug was not excluded from the prescription, and one might be continuously taking it without any requirement. By reviewing the prescription, people can eliminate such unwanted drugs and reap instant savings. Besides non-essential drugs, people should also check their prescription time and again to see whether they can include any generic drug in place of a branded drug. Generic drugs usually cost 85% less than branded drugs, but doctors generally not prescribed these drugs unless people ask their doctors or pharmacist.
Sometimes to reduce their prescription drug costs, people need to apply some common tricks like taking a higher dose pill less frequently, or splitting it. Sometimes people can also save money by switching from a capsule to a liquid form of medicine, though people need to check with their pharmacist whether it is feasible. People might also get a better deal if they agree to take two generics medications instead of one combo, as generics drugs are of low-costs.