How to help reduce the costs for Prescription Drugs
The start of a new year means a fresh round of out-of-pocket costs for people taking prescription drugs. Health-insurance deductibles reset on Jan. 1. That means, if your deductible applies to your prescription you will pay up to $545.00 in deductibles before your copays take effect.
New law passed with new savings.
The Inflation Reduction Act of 2022 contained some of the most sweeping drug-price provisions ever enacted. One of the earliest provisions to take effect, in 2023, was a $35 monthly cap on insulin costs for people on Medicare. Administrators of Medicare Part D drug plans were required to arrange for the caps to be applied automatically at the point of sale at a pharmacy or mail-order service.
Beginning in January 2025, there will be an effective annual cap on out-of-pocket costs of about $2000.00 for brand-name prescription drugs in Medicare Part D plans.
Shop for better prices!
Prices for the same drug can vary widely depending on where you buy it. For generics, check out the growing number of online discount prescription services. The Mark Cuban Cost Plus Drug Co. offers generic drugs at 15% markup plus pharmacy and shipping fees by cutting out pharmacy middlemen and negotiating directly with manufacturers. Amazon.com offers various pharmacy services including one that provides eligible medications for $5 a month.
Another online service, GoodRx, lets you compare prices for the same drug at several bricks-and-mortar pharmacies near you, and provides coupons that can lower the cost. A prescription for a generic version of the widely used cholesterol-lowering pill Lipitor, for example, costs up to $21.47 at one chain, while the same prescription costs $11.04 at a grocery-store pharmacy in the same town, according to GoodRx’s website.
“Medications can differ in price from pharmacy to pharmacy, and that’s something that a lot of people aren’t aware of,” said Dr. Karla Robinson, medical editor at GoodRx.
Try Canada?
It might also be worthwhile seeing if you can get your prescription at a lower cost in Canada. Drug importation is only allowed under limited circumstances under federal law, but both the Trump and Biden administrations have pursued policies to loosen restrictions. The agency says it may be allowable if the product doesn’t represent an unreasonable risk, if it is for personal use and the quantity is limited, among other criteria.
If you are interested is looking towards Canada to order your medications, give us a call for a list of Canadian drug stores that will ship to the USA.
If you are on Medicare, you instead might seek copay grants from third-party foundations. Usually, your income must be below a certain threshold. One of the largest, the PAN Foundation, operates an online tool to help people find a copay-assistance fund that specializes in their disease, including funds that other foundations operate. The foundations receive funding from drugmakers, but they are supposed to make the decisions about grants regardless of which drug they take.
If you’re a veteran, use VA benefits.
The U.S. Department of Veterans Affairs provides healthcare and drug benefits for eligible military veterans. For some members whose illness is connected to their service, there is zero cost. Other eligible veterans pay monthly copays of $5 to $11 for their prescriptions. The VA will help patients pay copays in certain cases. The VA can provide drugs at low cost partly because federal law requires certain discounts and allows the VA to further negotiate prices with manufacturers.
Call us with any questions or for more information on how to save money on prescription drugs.