Whether you take a medication on an ongoing basis or only fill occasional prescriptions, you need to plan ahead to save money. You don’t want to be surprised when you arrive at the pharmacy.
Knowing What Drugs Are Covered
Where to begin? It all starts with the list of drugs your health plan covers. This is commonly called a formulary. Both generic and name-brand drugs will appear on this drug list. Only medications on the formulary will be covered by your health plan.
Many health plans will place drugs on different levels (or tiers) based on how much the drug costs. There can often be three or more tiers on the drug list/formulary.
- Tier 1 — Has the lowest copayment. Includes the least expensive brand-name drugs and most generic drugs.
- Tier 2 — Mid-level copayment. Often includes brand-name drugs that have no generic substitute.
- Tier 3 and up — Highest level copayments. Includes the most costly brand-name drugs that your health plan covers.
Why is this important to know? Say your doctor prescribes you a brand-name drug. It is possible that this drug may have a generic substitute or a cheaper alternative. You can always ask if there is a drug on a lower tier level that is equally beneficial to you.
Remember to check your health plan’s formulary whenever you get a new prescription. As new drugs become available, health plans update their lists and may move a prescription to a new tier.
Generic Vs. Brand Name
If generic drugs are cheaper, is there a catch? Not at all! Generics have the same active ingredients and come in the same strengths and dosages as brand-name drugs.
Prescriptions By Mail
Do you take any prescription drugs regularly? If so, you may be able to save money by ordering these “maintenance medications” through the mail. Many health plans offer discounts for ordering through the mail.
Usually, you order a 90-day supply but only pay the copayment for a 60-day supply. It’s like getting a month free! Not only is it cheaper, but it is more convenient too. You don’t even have to visit the pharmacy.
This mail-order discount works best if your medication does not have any dispensing limitations, meaning you can only get a limited amount of the medication at one time.
Talk With Your Doctor And Pharmacist
By knowing your prescription drug benefits and discussing your medications with your doctor and pharmacist, you can be sure that you are getting the drugs you need at the best price. That should really make you feel good.