Buzz
Medications in the U.S. can be extremely expensive due to the lack of price regulations, exclusivity rights, and the forces of capitalism. But there are several ways you might not know about to help reduce prescription costs without sacrificing your health or financial stability.
Take advantage of apps or discount programs to lower prescription costs
Apps like GoodRx can be particularly useful if you don’t have insurance. Keep in mind that you cannot combine these apps or discount cards with your insurance—they’re either/or. Most of these apps are free, and although pharmacies pay a small transaction fee, they likely prefer this method since they get paid directly from you instead of waiting on insurance reimbursements. Plus, this could help build more loyalty to the pharmacy over time.
If you have a high deductible, a high copay, no insurance, or your insurance doesn’t cover a specific medication, options like GoodRx, RxSaver, and others can be helpful. Also, don’t forget to ask your doctor for any available coupons for your prescribed medications. Using discount cards and coupons isn’t quite like regular coupon-clipping—you’ll need to be specific and, in some cases, ask directly for them. Fortunately, with apps like GoodRx, you can see the prices for each medication at participating pharmacies, helping you choose the best pharmacy for maximum savings.
If a generic version of your medication is available, check if it’s listed on Cost Plus Drugs, the new online pharmacy created by Mark Cuban. This site offers over 100 generic medications, which users purchase upfront at a fraction of what they’d pay at traditional pharmacies. While the selection is limited and you’ll need to consult your doctor about switching to a generic, if your medications are available, you can expect significant savings.
Inquire about a prior authorization
Here’s a personal tip: When I changed jobs and switched my health insurance, I went to the pharmacy as usual to pick up my medicine. Instead of paying my usual $90, I was asked to pay nearly $500. After panicking, I contacted an insurance representative and easily secured a prior authorization, bringing my cost back down to around $50—less than it had been before.
A prior authorization, or preauthorization, is when your insurer determines that a service, treatment, drug, or piece of equipment is medically necessary and agrees to cover the cost. Your insurer should provide a list of covered medications on their website, but if you can’t find your medication, ask your doctor. For me, it was as simple as my doctor sending a note to the insurance company confirming that I needed the medication, so they should cover it. It might not always be that straightforward, and your insurer may push back, but it’s worth trying. I managed everything through the insurer’s website chat feature, so you may not even need to make a phone call.
Discuss your financial situation with your doctor
When your doctor prescribes a medication, you might not always feel empowered to be part of the decision-making process. However, if the cost of the medication is too high, it's crucial to speak up. This way, you can explore alternative options together, like switching to a generic version or a different drug that can work just as well at a lower cost.
Take advantage of a flexible spending account (FSA)
A flexible spending account (FSA) is an option available in some employee benefit packages. It allows you to move pre-tax dollars from your paycheck onto a debit card, which you can then use for health-related expenses, including prescription copays. Although it's still your money, the advantage of an FSA is that you don’t pay taxes on the funds, giving you some savings. Moreover, setting money aside for recurring health costs can help prevent a significant hit to your checking account each time you go to the pharmacy. Be aware, though—any funds left unspent by the end of the year are forfeited. So, if you contribute to an FSA, make sure you have a plan to use those funds. (Learn how to make the most of unspent FSA funds here.)
