Need To Cut Your Prescription Costs? Try Using This Script at the Pharmacy Counter
You can possibly lower your bill at the pharmacy counter if you ask about generic medications, discounts and refill quantities.
If the price catches you off guard or there’s a line behind you, figuring out what to ask can feel awkward. Ashley Robinson, PharmD, a pharmacist licensed in 16 states and pharmacy manager at the Clearwater, Florida location of TelyRx, shared four questions to ask before paying.
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Here’s what to say, how each could save money and which trade-offs to consider.
Inquire About a Generic That Costs Less
What to ask: “Is there a generic version of this, and would it be cheaper?”
If you’re filling a brand-name prescription, asking about a generic could lower your cost without changing the active ingredient in your medication.
“Generic medications work the same as brand-name drugs and typically cost less,” Robinson said.
The Food and Drug Administration requires approved generics to have the same active ingredient, strength, dosage form and route of administration as their brand-name counterparts.
Not every medication has a generic version. If one is available, ask: “Can you fill my prescription with that generic, or do you need approval from my prescriber?” Then, confirm what you would pay before making the switch.
Ensure Whether or Not Insurance Price Is the Lowest
What to ask: “Would this cost less without insurance or with a prescription discount?”
Ask the pharmacist to compare your insurance price with the regular cash price and the price using a prescription discount.
“In some cases, the cash or a discount card price may actually be lower than your insurance copay, even though that seems counterintuitive,” Robinson said.
Services such as GoodRx offer coupons you can show at participating pharmacies.
Per GoodRx, its standalone discounts can be used instead of insurance, including Medicare, but cannot be combined with that coverage for the same purchase.
A GoodRx coupon may save money today, but according to their website, purchases using its discounts instead of insurance don’t automatically count toward your deductible, the amount you pay before your plan starts covering certain costs. The company says some insurers may accept receipts for deductible credit or reimbursement. Check with your plan.
For Medicare, discount card purchases made instead of using your drug coverage don’t count toward your deductible or out-of-pocket maximum, according to Medicare.gov.
See if a 90-Day Supply Could Lower Monthly Cost
What to ask: “Can I get a 90-day supply, and would it cost less per month than a 30-day supply?”
Compare the actual prices. As a hypothetical example, a $60 three-month supply costs $20 per month. Compared with a $25 monthly fill, that saves $15 over three months.
“For maintenance medications you take daily for a chronic condition, filling a 90-day supply is often more cost-effective, when available,” Robinson said.
Ask whether your prescription and insurance plan allow a 90-day supply, which pharmacies can fill it and what the total price would be.
Find Out if Your Plan May Cover a Cheaper Alternative
What to ask: “Is there a less expensive medication my insurance covers, and can you check with my doctor?”
Here, you’re asking about a different drug for your condition instead of a generic version of your current medication. Your prescriber can determine whether switching is appropriate.
Your plan’s formulary is its list of covered drugs. Your insurance may cover one medication but not another used to treat the same condition, or charge you less for a preferred option.
“Ask your pharmacist if there’s another drug your plan may cover, and whether the pharmacy can connect with your prescriber to authorize the change,” Robinson said.
If you need the original medication and your plan doesn’t cover it, your prescriber may be able to help request a coverage exception. According to HealthCare.gov, Marketplace plans allow these requests, though approval isn’t guaranteed.
Ask who will contact your prescriber and when to follow up. If you’re about to run out of medication, mention that so they know how soon you need help.
This article was provided by MoneyLion.com for informational purposes only and should not be construed as financial, legal or tax advice.
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