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Cutting Rx costs
You might say the United States is a nation of pill poppers. Many adults take at least one prescription drug, but it's not uncommon for older people to be on five or more medications, according to the Centers for Disease Control and Prevention.
Even with insurance, drugs can be pricey. Without insurance, the cost may feel so exorbitant you may be tempted to skip or skimp on medication. Don't. There are ways to rein in the cost of prescription drugs, and skipping medication can be disastrous and ultimately more costly than the drugs themselves.
Confide in your doctor
Unfortunately, with the way our healthcare system is set up, it can be tough to comparison shopeven your doctor may not know what you'll end up paying for a prescription. But that doesn't mean he or she doesn't want to help you out.
Although it can be tough to admit cost is an issue for you, your physician would probably rather you did. One in five new prescriptions that are written are never filled, which drives doctors crazy. So if there's even a small chance you may skip the script because of money trouble, it's better to say so and work on solutions together.)
Use preventive care
Thanks to the Affordable Care Act, almost everyone can now take advantage of preventive services such as mammograms, colonoscopies, and vaccines. Seniors can also avail themselves of the one-time Welcome to Medicare visit, yearly wellness visits, and free health screenings to catch medical conditions early, when they are most treatable.
This may reduce the chance that you'll need to take multiple prescription medications down the road.
Check your formulary
Depending on your insurer's formulary (a list of medications that are covered), the copayments for two similar drugsfor example, Crestor or Zocor to treat cholesterolmay be wildly different. To avoid paying for the pricier drug, you need options.
When your doctor prescribes a new drug, ask him or her to list the top three choices, says Terry Bay, president of Senior Patient Advocates in Casper, Wyo. Check with your insurer to find out the copayment on each, and any formulary restrictions that might apply. Choose the best option and let your doctor know the drug you prefer.
"The doctors are generally very happy to have the patients involved in those decisions," Bay says.
Compare prices at pharmacies in your supermarket, retail stores, online, and via mail order. You can often find discounts for ordering a 30- or 90-day supply of medication. Take advantage of prescription discount programs. AARP, for example, has a program that provides discounts on FDA-approved medications that are not covered by Medicare Part D and are filled at a Walgreens retail and mail service pharmacy.)
If you order prescription drugs online, make sure the site is VIPPS-certified. Try to order all your drugs at the same pharmacy, however, so they can keep track of potentially risky drug-to-drug interactions, says Rich Sagall, MD, president of NeedyMeds.org in Gloucester, Mass. Otherwise, "nobody is looking over all the medications you're taking."
Ask for samples
Before you fork over the cost of a month's supply of a drug, you want to know if you can tolerate it, Bay says. If it's a brand-name drug, your doctor will likely have samples. Ask for 10 to 14 days worth so you can try it before committing, says Sagall.
Flip through magazines or find coupons online at sites such as Optimizerx.com and InternetDrugCoupons.com. Manufacturers often will offer a free 30-day trial or a coupon for a discount on the purchase of the drug. Be aware, though, that many of the coupons are for more expensive medications, says Janet Engle, PharmD, head of the department of pharmacy practice at the University of Illinois at Chicago College of Pharmacy and past president of the American Pharmacists Association.
Inquire about generics
"Ask your doctor if there's a generic medication that can be provided instead of a brand-name product," says Jeffrey A. Falk, RN, owner of Senior Health Care Solutions, in Plattekill, N.Y.
The cost of a generic drug is 80% to 85% lower, on average, than brand-name products, according to the U.S. Food and Drug Administration.
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Divide and conquer
Not all medicines double in price with double doses. "One of the things that some of our older clients have done [to save money] is they ask their doctor for a double-strength prescription and then they take half a pill," says Derek J. Fitteron, founder and CEO of Medical Cost Advocate in Wyckoff, N.J. That way, they save money but still get the benefit of the drug.
But the pill has to be designed to be splittable, which means it's scored down the middle, says Sagall. "If it isn't one that is obviously splittable, check with your pharmacist first," he says.
Lose the spare tire
Obesity drives up medical costs, and much of the extra expense is prescription drugs used to treat chronic conditions such as high blood pressure and diabetes. But you can do something about it. Even a modest weight losssay 5% to 10% of total body weightcould pack a huge payoff.
You'll see improvements in blood pressure, blood sugar, and cholesterol, and when your health improves, you may be able to cut back on medications.
Review your Part D plan
It may sound like a hassleand it can be. But reviewing your Medicare Part D plan options every year during the Medicare open-enrollment period can save a bundle. (This period starts around the middle of October and ends around the middle of December.)
Bay advises clients to compare plans based on total cost. Factor in the cost of drugs in each plan. "Don't shop by premium and deductible," she says. Over the past thee years, Bay's clients saved, on average, $1,500 to $1,600 each year by reviewing and switching Part D plans.
Get extra help
Medicare beneficiaries with limited income and resources may qualify for Extra Help, a government program that helps seniors with costs of a Medicare prescription-drug plan, including monthly premiums, annual deductibles, and prescription co-payments.
Extra Help is worth roughly $4,000 per year.
Tap state subsidy programs
Drowning in out-of-pocket costs? Many states have pharmaceutical assistance programs to help low-income seniors pay for gaps in coverage and cost-sharing not covered by Medicare Part D. To check what's available in your state, check out the Medicare site.
If your state has a program, "it can significantly cut the cost of your medication," says Eisenhower, of the National Council on Aging.
Go to the source
Don't give up hope if you can't afford the drug your doctor prescribed. Even if you don't qualify for state or federal discount programsor if coupons aren't cutting ityou may still be eligible to receive a drug for free or at minimal cost.
Many pharmaceutical manufacturers have so-called patient-assistance programs to help uninsured and low-income individuals. To search by drug name or drug company, check out Rx Assist, a patient-assistance program established with a grant from the Robert Wood Johnson Foundation in 1999.
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Don't add on drugs
Some doctors will try you on one medication for your condition, say hypertension, and if that doesn't work, add on another. If the second or third medication is the one that does the trick, ask your doctor if you can try ditching the ones that didn't seem to work.
"Don't just add on until you get control," says Sagall. "Once you add on, start taking away." But don't just decide on your own to stop taking medication; it can sometimes take more than one drug to control blood pressure, which can be a lifesaver.
Store medications properly
It may seem counterintuitive but don't store medications in the bathroom where it's steamy and hot. "This can reduce the potency," says Engle. "You don't want to open up an expensive bottle of medicine and see it all clumped together because it's full of moisture."
Consider over-the-counter alternatives
In some cases, an over-the-counter medication may work just as well as a prescription drug at only a fraction of the cost. For example, if the doctor prescribes a drug for allergies, ask if you can instead take Allegra, Claritin, Zyrtec or another medication available on pharmacy shelves, says Engle.
Keep in mind, however, that health insurance plans do not generally cover over-the-counter meds, so an Rx version might end up being less expensive than one you buy on your own, so compare costs.