Prescription Health Insurance: Five Ways to Save on Prescription Medications

In a climate of decreasing income and high health insurance premiums buying prescription medications can eat up a good chunk of your income, even if you are lucky enough to have prescription insurance. Here are some ways to help obtain necessary medications for less.·         

•  Generic medications: 

Insurance plans usually charge lower co-pay for generic medications. Generic medications are lower cost preparations of brand name drugs whose patents have run out.  Always ask you health care practitioner if a generic equivalent of your medicine would be just as effective.  Your doctor can advise you if a generic equivalent is not advisable (such as medications in which it is important to have a consistent steady state blood level of the drug) or even available.

A drug equivalent is not the same as a generic drug. They usually belong to the same class, may cost less but can just be as effective.  Ask your health care provider about this as well.

Pharmacy chains such as Wal-Mart and Sam’s Club have a list of over 100 generic medications for which they charge $4.00 for a month’s supply.  Many local pharmacies also have price matched this Wal-Mart offering so ask you pharmacist if they will match the $4.00 price.Check out Wal-Mart's $4.00 formulary here. Costco Pharmacy is another resource for less expensive generic medications. Anyone can avail of this pricing structure. If your health insurance co-pay is higher than $4.00, just buy the medicine outright.

• Understanding the tier structure of your prescription health insurance plan:

Note that your prescription health insurance may have different co-pay structures for different medications.  This is because there is a list of medications called a formulary.  The insurance health and pharmacy panel reviews the literature for the evidence base of the effectiveness of medicines for different conditions and they then assign these drugs to different tiers, usually first, second and third tier.

 Tier one include generic drugs which the FDA has determined to have the same bio-assayed ingredients and are as effective as the brand named drug. They have the lowest co-pay.

Tier two include brand named medications which are found to be effective for the conditions they are indicated and have middle range co-pay. Sometimes, the insurance company requires that a trial of a tier one medicine be tried before using the higher tier drugs.

Third and sometime fourth tier drugs are usually newer drugs for which effectiveness is still being evaluated. They have the highest co-pay which can reach over $100.00. Tier two to four drugs usually require a prior authorization from the insurance health plan.

• ·         Pharmaceutical company assistance:

Drug companies have indigent care subsidies for persons falling below a certain income level.  You will have to complete a form which details your income or lack thereof.  Your physician completes his part of the form and provides a prescription for a 3-4 month supply.  The medicine is either mailed to you or to the physician’s office.  You can avail of this service indefinitely as long as you fall within the guidelines.  Different companies have different requirements. Find a list of patient assistance programs here.

• ·         Prescription discount coupons:

Check with your pharmacy for discount coupons such as trial of new medication.  Your pharmacist can also find you the best deals on discount coupons for which you may qualify.

• ·         Take care of your health:

Living a health conscious lifestyle is the best way to save on health care cost.  Smoke cessation, mindful nutrition, exercise and learning stress management techniques can go a long way towards improving health.