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July 14, 2022
We’re living healthier and longer. For that we owe a big thank you to the scientists and doctors who make recommendations and medicines that make healthy living possible. But, prescription costs can dig into your budget. It is useful to know how to save money on prescription drugs, especially the drugs prescribed for chronic conditions that develop later in life.
As we get older, we end up taking more medicines, and that’s not cheap. According to surveys by Kaiser Family Foundation (KFF), nearly a quarter of Americans say it’s difficult to afford prescription drugs. Which should not be surprising as U.S. prescription drug spending per person is about double what it is in peer countries and about 8 in 10 U.S. adults say the cost of prescription drugs is unreasonable.
50-64 Year Olds: For people who are 50 to 64 and nearing retirement, three in ten say it’s difficult to pay for prescription drugs. This age group is squeezed from both sides: on one hand, they are more likely than younger people to be prescribed drugs, especially for chronic problems, but they are too young to qualify for Medicare.
Medicare Recipients: Once you qualify for Medicare, it generally becomes easier to afford prescriptions. Only 20% of Medicare recipients have trouble affording drugs.
Besides age, these are the factors that really contribute to drug affordability:
For those folks, the cost of healthcare, including medicines, is a wake-up call. Have you budgeted enough of your retirement savings to pay for healthcare — especially if Medicare won’t cover the cost?
To keep costs down, here are 15 practical steps to lower your prescription medication costs.
A study in California proved what we all know: it can be hard to talk to your doctor. Eight in ten people said they felt uncomfortable challenging their doctor’s authority, but be honest with your financial and health concerns. Ask questions and overcome your hesitation and make a plan that is good for your health and your budget.
Be sure to ask your doctor about alternatives to drugs – lifestyle changes may be more effective and far less costly.
Most of the major medical associations — the American Heart Association, American Diabetes Association, the National Heart, Lung and Blood Institute and more — recommend lifestyle changes called “Therapeutic Lifestyle Changes” (TLC).
TLC usually means improving your diet and exercise.
When being prescribed medicine for a condition, your first question to the doctor should be, “is there a generic version of this?” There may not be, but it never hurts to ask. Remember, don’t be afraid to tell the doctor you’re trying to keep costs low.
Doctors may also have free samples they can give you. Every pill you don’t pay for reduces your per-unit cost.
Don’t assume that prices are the same everywhere – they’re not. A study by Consumer Reports found that big-box stores like Sam’s Club and Costco were consistently cheaper than “brand name” drug stores like Rite Aid and CVS.
The Consumer’s Report research also found that your local independent pharmacy is also probably cheaper than a chain pharmacy.
Another upside of your local, independent pharmacies is that you can talk to them in person. Before the pharmacist runs your insurance, ask them about in-store discounts and whether they accept coupons. Asking for “all available discounts” can save you a bundle.
You can use websites like GoodRx to find the lowest prices locally. Just enter the name of your prescription and your location, and they give you a list of options and you can compare costs.
GoodRx are great for comparison shopping. They also often give you access to coupons. Other prescription drug coupon sites include Optum Perks. They give you access to coupons and vouchers for discounts, which makes them a doubly good deal.
Local doesn’t necessarily mean better if you can get more of your prescription at a lower cost online. Many chain pharmacies like Walgreens and CVS have online delivery options as do grocery stores like Kroger, Publix and Walmart.
If you are filling prescriptions online and having them delivered, be sure to make sure they have an accredited pharmacist listed on the website.
NOTE: If the site has a .pharmacy in the URL it’s a sign they’re legit.
Mail-order pharmacies also make it easier to buy medications in bulk, which saves time and money.
The economics of the pharmaceutical industry are convoluted, to put it nicely. If your insurance pays for medicine, you are obliged to foot the flat co-pay fee. Sometimes that means you’re co-paying $15 for a $10 prescription.
If your deductible is high, you might end up paying for the prescription out of pocket anyway. And pharmacies ask for your insurance automatically. So always do the math before you reach for your insurance card, and ask what it costs to pay without using your insurance.
Why is paying cash for gas cheaper than paying on a credit card? Maybe for the same reason that paying cash for your prescription drugs is cheaper than paying with your insurance.
Doctor David Belk’s book The Great American Healthcare Scam: How Kickbacks, Collusion and Propaganda have Exploded Healthcare Costs in the United States goes into detail on how drugmakers, insurance companies and pharmacies make more money by not telling you paying cash can be cheaper.
The bottom line is that you could pay less by asking if there is a cash price before you buy.
Getting a discount for prescription drugs is easy with a prescription discount card. FamilyWize, a non-profit, offers a popular card, as do for-profit companies like WellRx.
Discount cards are free and very helpful if you don’t have insurance — so what’s the catch? The short answer is, there isn’t one.
Drug discount cards work the same way loyalty cards work: cardholders are directed to a set of pharmacies who are participating members. The pharmacy pays the card issuer a referral fee, and in return, they get more business. Because some discount cardholders don’t have generous insurance plans, the pharmacy also gets customers who might have simply skipped buying the medication.
Medicare is like life: complicated and exhausting. Without going into the nitty-gritty of how to apply for and get benefits from Medicare, suffice it to say that you need to do your homework when looking at the Medicare plan you want.
Also keep in mind that Medicare, like most other insurance companies, has an election period (usually in October and November) when you can change or update your plan. If you miss this window, you may have to wait a year for your next opportunity. You can get more detail in Medicare’s official guide to prescription drug coverage.
If you are already taking a set of medicines, be sure that your prescriptions are on the Medicare plan’s “formulary” or list of covered drugs. If it’s not, you may be on the hook for the total price of the drug. Medicare has rules that allow your doctor to ask for your plan to make an exception for your prescription. Or you could ask for a different drug that is on your formulary and treats your condition, if that drug exists.
Medicare Extra Help is a program for lower-income Americans to get approximately $5,000 per year to help pay for prescription drugs not covered by their Medicare plan. You can apply here.
According to the SSA webpage, “to qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.”
The National Council on Aging (NCOA) defines Pharmaceutical Assistance Programs (PAPs) and State Pharmaceutical Assistance Programs (SPAPs) as programs that assist low-income seniors and adults with disabilities in paying for their prescription drugs. These programs generally provide “wraparound” coverage, which means they cover costs that Medicare Part D doesn’t pay.
Not all states have SPAP programs, and Medicare publishes a list of active programs. Medicare also has a website that helps members find assistance programs.
Be sure to use the NewRetirement Planner to see if you have budgeted enough savings for out-of-pocket medical costs.
The tool helps you get a personalized estimate of your out of pocket medical costs using your zip code, types of coverage you have and plan to have, your medical conditions and more…
The NewRetirement Planner is the most comprehensive and personalized way to create and maintain a reliable retirement plan.
With enough money saved and a smart approach to spending, your life will be long, happy and healthy.
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