Review these resources to see if there are ways you could cut down your out-of-pocket costs for the prescription drugs you need.
No single insurance policy, program, or discount card is likely to include every prescription drug you may need. To find the best prices and services, you should take some time to identify the program or programs that can best meet your needs. The Internet is the best way to access this information. You may want to ask a family member or friend to help you, especially if your Internet access is in a public library, community center, or Internet café.
Start by making a list of all the prescription drugs you (or your loved one) take, with the exact dosage and volume per prescription, and name of the manufacturer. For example: Zoloft, 100 mg per day, 30 tablets, Pfizer Inc. Then look at the prescription drug coverage you currently have. (Skip to the section on patient assistance programs if you have no insurance or drug coverage.)
Use your existing benefits and entitlements
If you have some coverage for prescription drugs, make sure you’re making the best use of it to minimize your out-of-pocket burden. Review your health plan manual.
- Are you following the plan’s rules about choice of pharmacy, the plan’s formulary (list of drugs approved for coverage) or “tiered co-payment” arrangements?
- Are you using a mail order pharmacy for medications you take regularly over time? Most plans offer savings for this. If you need drugs such as antibiotics or painkillers right away or on a short-term basis, you can get them at a community pharmacy even if you use mail order for your long-term needs.
- Have you discussed generic alternatives with your doctor?
Are You a Veteran or a Dependent of a Veteran?
Veterans, retired military personnel, and their dependents may be eligible for prescription drug assistance or coverage from the Department of Veterans Affairs’ Health Administration 877.222.8387 or www.va.gov/health_benefits or TRICARE www.tricare.osd.mil, the U.S. Department of Defense Military Health System.
Research patient assistance programs
The companies that manufacture pharmaceuticals make limited amounts of their products available to people in need at no or low cost through patient assistance programs. The eligibility criteria, application forms, and procedures for these programs vary, and a separate application may have to be submitted for each prescription. Before you despair, use the Internet to check out the organizations listed below. Their Web sites often include other valuable health-related information.
- www.needymeds.com
Is a nonprofit organization offering an easily searchable database of patient assistance programs run by drug manufacturers and others. It includes their application forms. - www.rarediseases.org
Is the Web site of the National Organization for Rare Disorders, or NORD. It administers medication assistance programs for uninsured or underinsured individuals with specific rare conditions. MS is one of them. - www.helpingpatients.org
Is operated by the Pharmaceutical Research and Manufacturers of America, or PhRMA. It lists all the patient assistance programs of its members, and helps users determine their eligibility online. - www.benefitscheckup.org
Provides individuals 55 years of age and older with a confidential personalized report of public and private programs that can help them save on prescription drugs.
Applications to patient assistance programs are generally free, but a few organizations will handle all the paperwork for you for a small fee. These include the Free Medicine Foundation at www.medicineprogram.com
Can your state pharmaceutical assistance program help?
Some states have created or plan to launch some type of program to provide pharmaceutical coverage or assistance, primarily to low-income elderly and/or people with disabilities who do not qualify for Medicaid. The programs offer savings paid for by the state’s government. Two organizations list details of each state’s program: the Medicare Rights Center (www.medicarerights.org, go to Medicare Basics, Help Paying for Prescription Drugs) and the National Conference of State Legislatures (www.ncsl.org/programs/health/drugaid.htm), which requires a no-cost online registration.
Investigate prescription drug discount cards
Prescription drug discount cards have existed for years, and have changed significantly in recent years. Often marketed using insurance terminology, it is easy to confuse these programs with health insurance, but they are not health insurance. They are membership programs that anyone can join for an annual fee. Typically, discounts are available for members at participating pharmacies only. Membership fees vary, as do the discount amounts. Be a good consumer by comparing prices, other benefits, and convenience. If the participating pharmacies are not nearby, do they deliver, and for how much?
Some cards also offer discounts on other health services by participating
providers only. Some are listed below. The Medicare Rights Center also provides a list on their Web site www.medicarerights.org under Discount Rx Resources.
Affordable Health Card
- www.affordablehealthcard.com
800.214.0611
A nationwide discount program for member individuals, groups, and seniors. The participating providers include physicians, hospitals, pharmacies, dental and vision specialists, and more.
AmeriPlan USA
- www.ameriplanusa.com
800.647.8421
Members receive discounts at participating dental, chiropractic, pharmacy, and optical care providers.
Medco Health Solutions
- www.yourplan.com
877.733.6765
Members receive discounts on brand name and generic drugs at participating pharmacies.
Nations Health
- www.nationshealth.com
800.977.9655
Members receive discounts at participating pharmacies.
Prescription Benefits, Inc.
- www.rxbenefits.com
800.377.1614
Members receive discounts at participating pharmacies
RxDrugCard
- www.rxdrugcard.com
888.216.2461
Members receive discounts at participating pharmacies
Together Rx Access Card
- www.togetherrxaccess.com
800.444.4106
Nationwide discount card program restricted to those who meet income guidelines and have no other prescription drug coverage. Discounts on approximately 275 prescription drugs manufactured by ten leading companies, no membership fee.
Should you buy drugs abroad or online?
The practice of going to another country, particularly Canada, to fill a prescription at lower cost (known as “importation” if the drug is manufactured abroad, or “reimportation” if originally manufactured in the United States), has become increasingly popular among people with high prescription drug needs. Even state governments are doing it.
Although the U.S. attorney general has stated that Americans who individually import their medicines from overseas will not be prosecuted, the practice is considered illegal. The FDA warns that it cannot guarantee the safety or effectiveness of any prescription medication that is beyond the reach of its regulatory authority.
The National MS Society urges people who are considering buying their drugs online within the U.S. or abroad to first review the FDA’s information at www.fda.gov/oc/buyonline
To do price comparisons online, try www.destinationrx.com.