Lowering your prescription cost
You may have insurance coverage but find that it still isn’t enough to cover the cost of your prescriptions. Some people find that they are underinsured: they have some coverage but it does not protect them from high out-of-pocket costs. Fortunately, there are programs to help qualified individuals get the care and medicines they need. 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.
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?
Some states offer discounts on prescription drugs for senior citizens and/or disabled residents who meet income eligibility guidelines. To see if your state has a prescription drug assistance program, contact your state Department of Insurance, or review information from Needymeds.org, which also has information about other state sponsored programs.
The manufacturers of the MS disease-modifying therapies offer patient assistance programs. Many other drugs used to treat symptoms or other conditions also offer help to qualified individuals. To learn about these other programs, their application forms and procedures, go to the website NeedyMeds.org. The website benefitscheckup.org works in a similar way and provides information about government programs and other benefits for eligible persons in need, including help with housing, heating bills and more.
You will need a doctor’s prescription to get any of your medicines, and that can be a problem for people with no health insurance. Do not hesitate to ask your doctor’s office or clinic for a reduced rate and/or a payment plan allowing you to pay your bills over time. One key to receiving a cost reduction is to ask the right person. You can ask your doctor if he or she will waive or reduce the bill for care. If you feel awkward discussing money with your doctor, the office manager or billing manager may be is a good place to start. For a hospital, you may ask to speak to the business manager or head of the billing office. You may also contact the hospital’s social worker. When possible, it can be more effective to make your request in person instead of by phone or letter.
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 “re-importation” 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