How to save money on medicines - part 2
B) For those with insurance that covers some/all of medicines
1) Insurance Formularies - many insurance companies use medication formularies. For many medications there are other medicines in the same class that work similarly. Let’s take hypertension (high blood pressure) as an example. There are a number of classes of medicines that can be used to treat hypertension - for example, diuretics, beta-blockers, ACE-Inhibitors, ARBs, calcium-channel blockers. Within these classes there are usually many medicines that are similar (some have minor differences). An insurance formulary may include one or a few medicines within a class rather than all of them. If your medicine is not on the formulary your insurance may not pay for it at all or you may have to pay a higher co-pay for it than for a medicine (in the same class) that is on the formulary. (If the medicine has a generic usually the generic will have the lowest co-pay.) Thus you may be able to save money by changing to another medicine in the same class that is on the formulary. Note: if you change medicines, you may need an appointment to be sure the new medicine is working (for example, checking blood pressure) and/or lab tests (for example, changing cholesterol medicines).
Unfortunately it is not always easy/simple for pharmacists and physicians to know which medicines are on various insurance companies’ formularies: we usually deal with multiple insurance companies (all with different formularies) and insurance companies have this nasty habit of changing which medicines are on their formularies (sometimes on a yearly basis). If you want to pursue this, for your medication find out what class of medicine it is, then find the names of other medicines in the same class then check with your insurance (call them or check their web site) to see which are covered and co-pays.
2) Mail in pharmacies - many insurances have, or contract with, pharmacies that will supply larger amounts of medicine for each prescription - usually 90 days at a time. Your co-pay is usually less than if you bought the same amount at a local pharmacy (especially if you got 30 days three times). These are usually located out of state and may take a week or more for the prescription to get to you. Check with your insurance to see if this is available and how much it would save you.
C) Prescription Assistance Programs (PAPs)
Many pharmaceutical companies have Prescription Assistance Programs (PAPs) for people who do not have insurance for medicines and/or have trouble affording their medicines. There are a number of programs with different features (for example, provide a discount/lower price vs. provide the medicine for free), have different requirements (for example the income level below which you would qualify) and cover different medicines. This can become a bit of a maze/confusing. Note that all of these programs and their information/requirements are subject to change - check specific programs for the most current information.
The first place to start is to do an internet (example: Google) search for the brand name of your medicine and go to the pharmaceutical manufacturers web site. Look to see if they have a prescription assistance program for the medicine.
Partnership for Prescription Assistance https://www.pparx.org/
Put in your medicine(s) and some information about yourself and it will search for PAPs for your.
Washington Prescription Drug Program Discount Card 800-913-4311
For all Washington residents (with or without health insurance, no income levels). You get a card through which you can get discounts at participating pharmacies on many medications. This can not be used with insurance for a prescription but you could use it for medicines that are not covered by your insurance and/or medicines for which the discounted price may be less than what you would pay with your insurance. (You may be able to use it while in the deductible part of your insurance.) You can enroll on line and can check on-line which medicines are covered and what the price would be.
GoodRx https://www.goodrx.com/ 866-809-9382
Lets you put in a medicine and compare prices at pharmacies. Also has discount/coupons.
Blink Health https://www.blinkhealth.com/rx 855-979-8290
Purchase on line at discounted price. Then pick up at many pharmacies.
Rx Outreach www.RxOutreach.com 800-796-1234
Discounts on medicines for those with incomes below certain levels. To qualify: income < $35,640 single; < $48,060 couple; < $60,480 family of 3. (Income levels different for Alaska and Hawaii.)