As healthcare costs continue rising, many members struggle with higher out-of-pocket costs for prescription medications. This is causing them to look for ways to save money on their medicinal benefits.
Pharmacists have several tools to help members save money on their medication costs. They can do a medication therapy review, which assesses all the drugs a person takes.
Know Your Copays
Copays are fixed fees for specific health services, like doctor visits or prescription medications. They may not be for every service you receive, but they can help manage costs and save money.
Copay fees are usually around $25 but vary based on your health plan. If you need to see a specialist or have an emergency room visit, you might be required to pay higher fees.
Your copays also depend on the type of drug you need. Many plans have a formulary where the list of covered drugs is broken down into groups (tiers) based on cost.
When you get a prescription, your price will be based on your plan’s drug tier and deductible. Your plan might also require you to pay a copay before it starts paying for the drug.
The lower your tier, the cheaper the drug will be for you. Ask your doctor or pharmacist if you need help determining which tier your drug is in.
Ask Your Pharmacist
If you find yourself with a prescription that costs more than you can afford, ask your pharmacist if there are alternatives. They can work with you to find affordable options, including generics or a 90-day supply.
They can also determine if your insurance plan offers discounts or other programs that might help you pay for your medicine. Some states offer such patient assistance programs, and pharmaceutical companies provide savings such as CVS coupons and others.
An excellent way to save money is to get a copy of your medication formulary and compare the costs of different drugs.
Your pharmacist can also review your list of medicines and recommend cheaper ones to replace expensive, brand-name medications. They can also suggest ways to ensure you take your medications safely and correctly.
They can also discuss your other medications and over-the-counter products to see if they interact with your prescriptions. This can help prevent drug interactions and side effects that could be dangerous or even life-threatening.
Shop Around Locally
Shopping locally can help you find the best prices for your medications. A local pharmacy can save you money if you’re looking for generic or brand-name prescriptions.
Shopping locally can help you support your community and strengthen the economy. This is particularly important when independent pharmacies and small businesses struggle to survive.
A local pharmacy offers personalized care that goes beyond your prescriptions. They also provide point-of-care testing, vaccines, and medication therapy management, which can help you maintain your health for a long time.
Your local pharmacist is also your go-to source for advice and information about your hygiene products, OTC meds, and even first aid supplies. They can help you determine which antibiotic to take when you’re sick or give you the latest community updates.
Shopping at your local pharmacy can also help you save money and energy by reducing the number of stops you have to make for your healthcare needs. In addition, you’ll enjoy the same high-quality customer service from your neighbourhood pharmacist as you do from a big-box store.
Look for Manufacturer’s Savings Programs
Manufacturers’ savings programs are a dime a dozen and can save you and your employee’s hundreds or even thousands of dollars on prescriptions. Whether it’s a manufacturer-branded discount card, an online rebate program or a special coupon redeemable at your local pharmacy, you can save big with a little effort and some elbow grease.
One of the most effective ways to cut your drug costs is to enlist the aid of an experienced and transparent pass-through pharmacy benefits manager (PBM). A good PBM will have a variety of tricks up its sleeve, from reporting to outreach on solutions for high-cost medications to verifying contracts at the highest level. They also have a staff of seasoned experts on hand to help you navigate the complexities of your insurance plan and keep your members on the proper medication at the right price.
Check Your Insurance Plan
Knowing your insurance plan is critical to making the best healthcare decisions. It gives you the information you need to avoid unexpected costs and helps you find and use the services you want at a price you can afford.
Health plans have different benefits and rules, so checking them carefully is essential. Your summary of benefits and coverage (SBC) and doctor search tool are available online through your insurance company.
The first step is to check that your insurance covers the doctors, specialists and clinics you want. These are called your “preferred providers” or “in-network providers,” They typically charge you less than non-preferred providers.
Also, ensure you understand the formulary – the list of medications your plan covers. This usually consists of generic drugs, although some brands may also be included. It’s a good idea to know which drugs are in which tiers to understand how much your copay will be for each drug.
