What To Do When You Can’t Afford Your Medication
Recently, the price of two life saving medications have skyrocketed, adding to the large paychecks of the corresponding CEO. Healthcare and medication have entered the political spotlight and are under scrutiny for its high cost and lack of availability to everyone. This has been a hot-button topic for the current presidential candidates this year and in the past few elections with the Affordable Care Act bringing major changes across the board. Regardless of your political beliefs, I think we can all agree that these jumps in cost are pretty unethical and exploit people who may need these medications to survive.
Having worked with low-income patients in a healthcare setting for the five years since I graduated college, I have picked up a few tricks that I am going to share so that people can know their options and prevent these huge drug companies from making an absurd profit off of your medical condition.
First, you are going to want to have health insurance. In the U.S. it is required and you will have a tax penalty if you are uninsured. Insurance will usually pay at least a portion of your medication costs. Different types of insurance include private, commercial insurance through your employer, insurance purchased through the marketplace, or public insurance like Medicare or Medicaid. Make sure that you have the insurance that is most appropriate for your situation. If you are having trouble getting the medication covered by your insurance, talk to your doctor. In some cases the doctor can send medical records to show the medical necessity of the medication and then the insurance company will cover it.
This may not be an option for everyone, but you may have the chance to contribute to an HSA or FSA plan through your employer. HSA stands for Health Spending Account and FSA stands for Flexible Spending Account. Speak to your human resources department for further information on your specific options. These both require a pre-tax payroll deduction which gets deposited into a savings account for you to use towards medical expenses. Be sure to read the fine print, as in some cases the money can expire if it is not used within a certain time period.
When a new medication is cleared for use by the FDA, it will be patented. The patent will end and other companies can begin making a medication with the same chemical formula and selling it. Since they don’t have the up front cost of research and testing, they can (and do) sell it much cheaper. Discuss this option with a doctor before making the change. It is rare but it is possible your body may not react as expected to a generic. I am not a doctor, please do not take anything I say as medical advice and consult your doctor before making any changes.
This can be hit or miss, it will depend on your specific doctor’s office. If there is no generic available for your medication, often there will be a representative from the drug company that visits your doctor and leaves samples to be given to patients with the idea that they will try the medication and stay on it and continue to pay for it for years to come, making money for the company in the long run. (Check out the move Love and Other Drugs if you want a rom-com that goes more in depth than this post about pharmaceutical reps.) Some doctors may only provide samples in certain situations, and likely not long-term.
This is a more long-term solution than the previous option. Check out the needymeds website and find your medication. There will be an application to be completed and returned and possibly additional documentation to be provided by you or your doctor. You will have to review that specific program to see if you meet the requirements. If you have questions, be sure to ask your doctor. Once you have sent in the application, within a week to a couple months, you will have your medication mailed to you or your doctor’s office at little to no cost to you. Most programs are free, read the fine print to know if your medication will be free or you will have to pay a small cost.
Prescription Discount Card
This is somewhat of a last resort. If all else fails or it could be combined for maximum savings if you get your medication from the pharmacy (rather than via samples or Patient Assistance Programs). I get these in the mail periodically and I typically see them sitting out in the lobby at doctors’ offices. If you don’t see them, ask for one. It works kind of like a reusable coupon. You will scan it at the register for a percent off of the cost of your prescription. Make sure to find out if or what discount your mediation is eligible for ahead of time.
If you want an even further discount on your medication, you may want to consider what rewards you could get from paying for it. This could be in the form of a store/ pharmacy loyalty card that offers a discount on gas or making the purchase with a rewards credit card that offers a percent cash back. Sometimes grocery stores or drug stores will offer a big bonus for transferring a prescription Be careful of doing this more than every once in a while, you may be flagged for prescription drug abuse as this is behavior that is frequently associated with people trying to beat the system.
This will absolutely not apply to everyone or every medication. Sometimes you can make lifestyle changes and you may no longer need your medication. This should be something discussed with your doctor. Please do not jeopardize your health to save money. Also, again I’m not a doctor, but I do personally know people who have made healthier choices and their doctor decided to reduce or discontinue some of their medications. You may also be able to change to a more affordable option. Your doctor should be able to help with this.
While these tips may not be applicable to everyone in all situations, I really do hope that it helps someone. How have you saved on a prescription? Have you been affected by the rising cost of your medication?