Prescriptions costs are skyrocketing. We all know that. But did you know that there are several ways for employees and individuals to save money on their monthly medications? Here are a few ideas that are worth sharing with your clients.
Generic drugs are generally chemically and therapeutically equivalent to their brand name counterparts. In most cases, they’ll work just as well but at a fraction of the price. Many insurers have fliers about generic drugs that you can share with your clients. You might also want to see what material is available at your local pharmacy (just make sure the pharmacy is part of the provider network for your client’s plan).
In some cases, the $4 or $5 generic drug programs at some of the country’s leading pharmacies will be less expensive than the insurance price. For clients with a Health Savings Account, it is worth pointing out when it might be better not to use their health insurance plan, which is a big part of training clients to be better health care consumers.
Most brokers advise their clients to stay in-network whenever possible when receiving care. When using the carrier’s prescription benefit, though, using in-network providers may not be enough; your clients may need to use the carrier’s preferred pharmacies. Some carriers now have two levels of contracted pharmacies – preferred and non-preferred – and using the preferred pharmacies will get the member lower copayments or bigger discounts than the non-preferred pharmacies. Every little bit helps.
Consumers often do not realize that different health care providers contract with insurance companies at different prices. This is true with pharmacies just like it is with doctors and hospitals. Fortunately, many carriers are now offering pricing tools that will allow members to log in and “shop” for prescriptions before heading to the drug store. It’s not always enough to switch from a brand name to a generic; the member may also need to switch pharmacies to maximize his or her savings.
U.S. mail-order pharmacies may be able to dispense prescription drugs at lower prices than retail pharmacies. As prescription drugs in the U.S. move from manufacturer to the retail consumer, their prices get marked up by a series of middlemen increasing the price significantly above its original wholesale cost. MailMyPrescriptions is one such provider through which consumers can purchase FDA-approved generic drugs originated from many of the same U.S. based pharmacy wholesalers used by retail drug stores, except that the prescription cost is well below the suggested list prices, thus saving customers money. Today, customers can get over 1,400 generic drugs at cash pay wholesale prices shipped to their door within five days according to a guarantee from MailMyPrescriptions.
As we’ve already mentioned, just because you have insurance doesn’t mean you have to use it. Sometimes it’s more effective to go outside the health insurance plan if there is a bigger discount to be had. And with the various prescription discount cards that are available, that is entirely possible. When you consider all of medications and all of the pharmacies consumers have to choose from, it’s easy to see why a discount program might be able to beat the health plan’s discounts at least some of the time, especially on non-formulary drugs. A free prescription discount card is available for all LIFE Association members.
Pharmaceutical companies call on physicians all the time to educate them about the medications they offer and encourage doctors to prescribe those medications to their clients when appropriate. As part of this effort, they often provide physicians with samples that they can use with some of their clients. Our advice: tell your clients not to let those samples go to waste. If they’re having trouble paying for their prescriptions, patients can ask their doctors if they have samples they can provide. The worst they can say is no.
Most pharmaceutical companies have a program available for people who cannot afford their prescription drugs. The type of assistance and qualification criteria will vary, but if your clients are having difficulty paying for an expensive prescription medication, you should encourage them to contact their doctor to see if he or she can help them apply for a prescription assistance program.
Health Savings Accounts continue to grow in popularity, and with the next round of premium increases it’s likely that even more of your clients will select an HSA-compatible option. Be sure to remind them to set up their account right away and then use their HSA card to pay for eligible expenses, including prescriptions, with tax-free dollars. Depending on the consumer’s income level, the tax savings can often add up to 20 to 30 percent or more.
One final suggestion is to encourage your clients to make lifestyle choices that might reduce their need for at least some of their monthly prescriptions. True, brokers may not have much influence over what their clients eat or how much they exercise, but we can certainly point out any resources that are available. Most insurers have some sort of wellness benefits or health perks available at no charge, so make sure your clients are aware of these programs. Who knows – maybe they’ll actually give them a try.
This is not a comprehensive list of money-saving ideas, but it is a good start. The point is to let your clients know that health insurance plans are becoming more catastrophic in nature, and that means that people will need to become better health care consumers. Sometimes that means using the tools that the insurance company offers at no charge. Sometimes it means using discounts and other resources that are available outside the health plan.
Unfortunately, creating better healthcare consumers does not happen overnight. It takes education and repetition, so use this list as a starting point, add your own ideas, and share it with your clients and prospects.