Need Affordable Prescription Medications? Try This Money-Saving Tip
I’m probably not telling you anything you don’t already know but, geez, prescription medications are expensive!
Even after you’ve shopped around for the best price, downloaded pharmacy discount cards, checked for generic equivalents and asked your doctor for samples, the cost of meds can easily eat away at the most solid of budgets.
Sometimes when you think you’ve run out of options, someone comes along with one more thing you can try.
Today that someone is Keith Speights from investor advisor website The Motley Fool.
Among the list of things Speights suggests to help lower your prescription drug costs, he recommends taking your insurance company’s drug formulary with you to your next doctor appointment.
“Ask your doctor if the drug being prescribed has alternatives, then check the formulary to see which one is the least expensive for you,“ he says.
Except… I wasn’t sure what that meant.
So, I did a little legwork, and, in case you’re also not sure what a drug formulary is, I’ll share with you what I learned.
A Drug Formu-What?
A drug formulary is simply a list of prescription medications covered under your health insurance or prescription drug plan, according to HealthCare.gov.
It can’t be that simple, can it?
Just because a medication appears on a drug formulary doesn’t mean you can just walk into a pharmacy with a prescription and walk out clutching a bottle of pills.
Oh, no, no, no.
The Reality of Drug Formularies
“The formulary process is supposed to save money for you and your insurer, but it’s often a hassle,” explains NerdWallet. “To get an expensive drug covered you may first have to try a similar one, or have your doctor prove you need it, and that can take weeks.”
Been there, done that.
Not long ago, my doctor prescribed a medication that was clearly listed on my insurance company’s drug formulary (or, as I call it, “the list thingy”).
I zipped over to the pharmacy to pick up my meds and was floored when they handed me a bill for $821.
When I called the insurance company to ask why the tab was so high, they told me I had to take a similar medication for a month to see if it would work instead.
If not, they’d consider approving the original medication.
No amount of pleading from me or intervention from my doctor would change their minds, so I took the alternate medicine. Predictably, it didn’t work as well, so I ended up on my doctor’s first choice — which insurance happily paid for.
I don’t get it either.
But the fun didn’t end there.
By the time I needed the medication refilled, the insurance company’s drug formulary had changed and now that med was no longer covered.
But the one I’d tried first now was. (Oh come on!)
The price tag on this medication was $610.
Lesson learned: the list of medications on a drug formulary isn’t set in stone and can change at any time.
Where Do I Find My Insurer’s Drug Formulary?
Most insurance companies post a drug formulary list right on their website. It may be a downloadable list or a searchable database.
If you can’t find what you’re looking for, call the number listed on your insurance card and they’ll hook you up with what you’re looking for.
What If the Medication I Need is Non-Formulary?
If a medicine you need isn’t on the magic list, it’s considered “non-formulary” and your insurance company typically won’t pay for it.
However, there is one thing you can try.
“If you and your doctor believe that the non-formulary medication is necessary, you will need to request that your insurance make an exception based on your case,” says SafeMedication.
If your insurance company still won’t budge, talk to your doctor and pharmacist. They may know of options or alternatives that could help.
When my insurance company pulled the medication switcharoo I mentioned above, my pharmacist found a prescription card on the manufacturer website that knocked the final price down to $108.
Still a hefty price, to be sure, but at least it wasn’t 600 bucks.
Lisa McGreevy is a staff writer at The Penny Hoarder. Expensive medications are all the motivation she needs to stay as healthy as possible for as long as possible.