Can You Stretch Your Prescription Dollar?

Community Member

Well, the simple answer is YES With some shopping around and doing some investigating, you can stretch your rx dollars. Several years ago I went on Long Term Disability and SSDI which led me to Medicare. The first thing I found out was that I either had to stymie the flood of money going to my pharmacy, or acquire a taste for pet food in my new home under the bridge! We chose to cut back on rx spending!

One thing I would like to say right up front is DO NOT try to save money by cutting your pills, or skipping doses! Many of the meds we take are time release and cutting them can release the full dose immediatley, which is VERY dangerous. Skipping doses can render the medication useless. Please speak to your doctor with any questions about this.

A lot of this sharepost has to deal with Medicare, but some of it translates over to private insurance as well. Hopefully you will find some hints that can help save you a few dollars or more with the sometimes VERY expensive medications we all take.

One of the first things I did look into Medicare Supplement Plans. Medicare, on its own does NOT cover rx medications. You need Part D to cover rxs. You will need to contact your local SSDI office or check online here. Many supplement plans are regional only and available to certain parts of the country. Most sites have "calculators" where you can enter your medications and recieve an estimate of what your yearly out of pocket cost will be. Make sure you also check the plans "formulary" (what meds are covered) to ensure meds like Biologics are covered. I finally settled on a plan, but before I signed up, I contacted an Insurance Broker to look the plans over as well. This was very helpful as a lot of the sites are full of legalise and they all claim to be No. 1. My broker also picked the plan that I had settled on, giving me peace of mind. Also check on what your costs may be during the "donut hole" which we all will face due to the cost of the drugs. Face it, most of us take a huge assortment of medications, some of them very costly, and in this global economy every dollar counts. Do your homework and you can come out ahead of the game in this category.

The next person I approached was my Doctor, well, in my case Doctors! I explained my financial situation and we looked into options. I was very surprised at how many of the drugs I take could be replaced with either a generic equivalant or another drug that could replace it at a huge savings. It is not a fun thing to discuss with your doctor, but mine were very accomadating and understood. They preferred me to stay ON the medications, and being able to afford them was key to that. I would estimate I saved nearly 1/3 of my monthly costs here alone. Another thing to speak to your doctors about is having your refills written for a 90 day supply instead of a 30 day. Many insurance companies have a lower out of pocket amount on a 90 day supply.

Speaking of Insurance Companies (try not to cringe........ I understand!) You may want to contact them to see if they offer any coverage for a mail order pharmacy. Many companies use these mail order pharmacys to cut costs, theres and yours! I have used these companies and found them to be reasonable to deal with. I do keep some of my more important meds, pain meds etc at my local pharmacy to have better access to them. When I was on Humira I had it mail ordered and it was always on time and delivered in a chilled cooler. Never had an issue!

If you are on private insurance, NOT Medicare or Medicaid, you may also be able to take advantage of Drug Manufacturers specific plans for drugs. For instance, Humira, Orencia, Rituxan and many other drugs offer co pay assistance for many patients. I would urge you to read Lisa Emrichs post on this here. She offers a ton of advise and contact info for many of the drugs we take, a really great post from one of our own! Unfortunatley those of us on Medicare cannot take advantage of these offers as the Federal Government sees this a "kick back" to take the medication. I have spoken to Senators and Representatives about this issue and will speak to them again this fall.

If you are on Medicare, there are a few places that can still help you. Number one is to check with SSDI and Medicare first to see if you qualify for extra help! They make it very easy to apply and find out if you are eligible. You can find help with this here. If you are not eligible, like me, there is still hope! I have spent many a dreary eyed night looking for assistance from foundations. If you google it, you can find many sites that do offer some sort of assistance for Autoimmune disease-related medications. The key here is most will only assist you, if you qualify, if they are the ONLY foundation helping you. The one I finally settled on and was approved for was the HealthWell Foundation. A 501C that assists people in our situation. I was granted $2800 in copay assistance for my biologics! That was a huge relief, and worth it for you to look into!

Another simple way to save is to cost shop your pharmacies! I was unaware that some pharmacies have a mark up of up to 800 percent! Thats no typo! I meant 800 percent! If you have a local Costco, they have the lowest markup on rxs around. My wife and I have executive memberships and the savings on rxs alone pays for our yearly membership! Shop around and dont pay more than necessary! WalMart and many supermarket chains now offer generics for $4 or less a month, and many offer a list of what meds are included. Speaking to the business manager at your Rhuemys can help as well, many offer payment plans, some with their own credit card with low to no interest involved. Some offices also will write off the 20 percent copay. It cannot hurt to ask!

All in all, I was able to slowly lower my out of pocket rx costs by more than 50 percent! You can certainly save some money just by doing your homework and checking every option that you can. I sincerely hope that this does help you, and if you have any other tips on saving money with rxs, please post them here! We will all thank you!