If you’re willing to do a little extra work, it is possible to lower your prescription bills.
A reporter for The New York Times and a reporter for ProPublica both found instances this year in which drugs prescribed for family members could be purchased for less money without using their insurance coverage.
Before you go to the pharmacy, check to see what your cost will be. Most of the big pharmacy benefit managers (the companies that manage your drug benefits on behalf of your insurer) allow you to search for drugs on their websites to see what you’ll owe. This cost will vary depending on whether your plan requires you to meet a deductible, which is a fixed amount before your coverage kicks in; make a co-payment; or pay a percentage of the list price. The major pharmacy benefit managers are Express Scripts, OptumRx and CVS Caremark.
Determine whether your drug is a newer, brand-name drug that is sold by one drug maker at a premium, or whether it is a generic product that is often cheaper and sold by multiple companies. If you’re unsure, ask your doctor.
Several large retailers, like Walmart and Costco, sell generics at discounted prices, like $4 a prescription, which may be less than your insurance is asking you to pay. Some grocery stores, like Publix and Meijer, even give away certain medications — like antibiotics — for free. Pharmacy chains like Rite Aid also offer discounted prices to people who sign up for savings clubs.
GoodRx and Blink Health are two companies that offer discounted rates on generic drugs. GoodRx allows consumers to compare what local pharmacies are charging for a drug (it includes prices from discount stores like Walmart), while Blink Health quotes a single price that it has negotiated. GoodRx offers coupons that consumers bring to participating pharmacies, while Blink Health requires users to pay upfront, then collect their prescription at a nearby pharmacy.
Check the website of the drug you’re taking. Some companies offer discounts (often called copay coupon cards) to help cover insured patients’ out-of-pocket costs, at least for the first few months. But people who are covered by government programs like Medicare are prohibited from using these programs, and sometimes the discounts are capped for those without insurance.
Depending on your income, you may also qualify for patient-assistance programs, which are either run by the drug maker or a charity that is financed by the drug maker.
Drug makers do not necessarily offer these programs out of a sense of charity — the programs help boost their bottom line by ensuring that patients will continue on their drugs (while sticking insurers with the bulk of the drug’s bill). And sometimes the help is more trouble than it’s worth. Some discounts are valid for a limited period, leaving patients in the lurch when they expire. Other programs can end without notice. But for those with little other choice, every bit helps.
Also, it never hurts to ask your doctor if there is a similar drug available that may cost you less.
Many pharmacies — especially independent ones — offer cash-paying customers prices that are lower than a drug’s sticker price. When handing over your insurance card, it’s worth asking if you can get a better deal by paying cash.