A Summary of Medical Savings Ideas

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The first step in reducing prescriptions is going to appear to be very simple. It may or may not be.

Make a list of every prescription medication you and your family have used in the last 12 - 18 months. Every one. Whether it's a medication you use every day, like insulin or glucophage, or a one-time-only antibiotic, whether it's an inhaler you use periodically, or just an Epi-Pen to keep on hand, add it to the list.

If you have recently changed Rx to treat the same condition, list both medications. If you are considering a new or alternate medication, add it to the list.

It may help to look through your tax receipts. Collect any Rx receipts you can find; not the cash register receipts, but the actual medication description, warning, and cost sheet.

At the end of this process, you should have a list, similar to

Regular:
Rx #1
Rx #2
Rx #3
Rx #4

Periodic:
Rx #5
Rx #6
Rx #7

Former:
Rx #8
Rx #9

Future:
Rx #10
Rx #11

That's all you need to do for this step. But be thorough, and include every medication you can possibly think of. <!-- -->

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Reducing Rx costs, Step 2: Make a Price Book

The most important step in reducing your Rx costs is knowing what you are paying. It may not be obvious. Copays, prescription cards, tiers and levels. But it can be sorted through.


First: next to the list of meds, write down the size pills/inhaler/that is prescribed. For example, Zyrtec is typically 10 mg size tablets.

Next: convert that to the number of pills/inhalers/injections etc. that an average prescription would be each month.

Example, Zyrtec, 10 mg each night is 30 per month. Zoloft, 50 mg pills but three each day is 3 x 30 days = 90 pills.

For inhalers, assume, for this exercize, one per month.

Etc.

NOW: add two columns: the price your pharmacy charges, and the price you pay. Even if you have a low copay, or are on a medical discount card, look at the medical receipt for what the insurance rate charged, and what you pay.

Example, with a discount plan, the pharmacy rate for Zyrtec is $128, but the discount plan rate reduces the actual charge to $94.

You should have something that looks like:







That's the first step. <!-- -->

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Reducing Rx Costs - Step 3: Pill Splitting

Pill splitting is a great way to reduce your prescription costs. Always check with your doctor AND pharmacist before splitting pills! Never split an extended or time released tablet!

Pill splitting is simply purchasing a large size tablet, and cutting (spliting) it in half. Pills that can be easily split are scored (have a line indent running down the middle of the pill) which aids in the ability to snap them in two (along the line).

For example, instead of taking 3 50mg tablets of Zoloft each morning, pill splitting would allow you to take 1.5 100 mg tablets. The cost savings?

90 50mg tablets (one month of 150mg each day) are priced at $310. 50 100mg tablets (one month of 150mg each day) are priced at $182. SAME DOSE, DIFFERENT PRICE!

Adding this information, go back to your list, and consider what pills might be available in larger sizes that can be split. We'll look into this more later. For now, let's add some possible pill split savings into our table.

[MOM2SNOX]

I know you're just testing this thread but holy moly! Talk about some serious savings! I never thought about splitting prescriptions! What a difference!

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Reducing Rx Costs: Step 4: Price Comparison
You might assume that if you are on an insurance plan, prescription plan, or even a discount plan, the costs from one pharmacy to the next will be the same.

There are two reasons. First, if your medications are not covered, obviously you want to get the lowest prices you can.

But...did you know that your insurance price may not be the lowest price?

Frequently a pharmacy lowers their standard prices to meet the insurance negotiated prices. However, several pharmacies, such as Costco, guarantee to provide your prescriptions at the insurance price OR their price, whichever is lowest. And, surprisingly frequently, the Costco price is lowest. There are many reasons for this, but the only important one for this exercise is, are you paying the lowest price possible.

To see how your rates compare, check online sources. For this example, we will use Costco.com and drugstore.com.

You don't need to be a member of costco.com to compare their prices. Simply go to www.costco.com, click on the "Pharmacy" menu up top, and on "Learn More/Pricing Information" on the page that follows.

You may type in a medication name, or select from their list. A link to the drug, or possible drugs, will appear. Select the link, and scroll through the prices to determine your dosage. Check prices for various pill sizes, and even quantities.

In your spreadsheet or table, add a column and record the prices of each medication in the size and quantity per month you have previously calculated for your current pharmacy.

Remember, insurance prices MAY be lower, this is their default price.

After you have made it through all your medications, repeat at www.drugstore.com

Select Low Prices from the left menu, and perform a drug search as before.

You should now have a table something like:







Now...remember, you do not have to buy ALL of your prescriptions at the same place. If the prices are the same at your regular pharmacy for most drugs, do what's easiest. BUT, if for even one drug you find a significant price difference, consider purchasing at least that one elsewhere.

NOW, I'm NOT recommending Costco or Drugstore.com, these are examples. Do your own research, and see what you can find for your own needs.

A few other things to factor in...if you use a 5% cash back for drugstores, if you have executive membership and AmEx with Costco (3% back), if you can purchase bulk quantities (3 months at a time)...factor all those possibilities in to find the best savings for you.


Happy Saving. <!-- -->

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Some final tips for reducing Rx costs:

Even if you are getting great prices at your pharmacy, there are a few ways to achieve additional savings!

1. Samples. Ask your doctors for samples of the medications they prescribe. Be up front about any difficulties you are having in paying for prescription, or let them know how much that monthly Rx costs.

Doctors receive daily visits from various pharmaceutical sales reps, including samples, coupons, and other offers. The newer the medication, the more likely they are to have samples available. However, doctors are busy, and see many patients, and may not think to offer the samples, unless you ask!

Specialists in private practices (gastro, cardio, etc.) usually receive additional volumes of samples; after all, their patients are the most likely to use them. Just ask!

2. Coupons and Vouchers. Coupons and vouchers for free samples, discounts at your pharmacy (also referred to as pharmacy checks), and rebates are increasingly common. Even if you are already on a medication, your doctor may write a separate prescription for the free sample, in addition to your regular prescription.

Several offers are listed at

Rx Coupons

Once you fill a trial or use a prescription coupon, the manufacturer will generally provide another. And another…

Several programs also have “Rewards Programs”, allowing you to submit your receipts for rebates and free gifts. $40 - $200 a year in cash back, as well as freebies, can add up quickly in reducing costs.

Don’t assume you cannot use coupons with copayments or insurance plans. In general, you can. The major exception is when your medications are completely covered by Medicare (some breathing meds, diabetic supplies, etc.), in which case you would be being paid to take a drug (not allowed). Your pharmacist will know the requirements and are generally very supportive.

3. Contact the Manufacturers Most manufacturers have prescription assistance programs. While these are changing dramatically with the changes in Medicare plans, they do have programs available. Programs generally require input from your physician, and some program provide the medications directly to your doctor to pass on at regular appointments.

4. Pharmacy Rewards. With the introduction of medicare plans, many patients were required to change pharmacies, or even utilize mail-order programs to meet the insurance requirements. Pharmacies are now offering incentives to keep and bring in new business. $25 gift cards for new or transferred prescriptions are now common.

For new prescriptions, the free trials work well: no need to pass on insurance information, no need to pay for medications, and you get a gift card!

For transferred prescriptions, there are several things to consider. First, no matter what the pharmacy’s price points are, you can transfer a generic or low cost prescription and still generally come out ahead. Second, if the medication is covered under your prescription insurance plan, the costs should be similar (not necessarily the same), between pharmacies. Call and ask the price before you transfer, and make sure you are benefiting by the offer.

Also, remember, transferring a prescription does not mean it needs to be filled at that pharmacy in the future. Just take your empty bottle back to your preferred pharmacy and have it transferred back when it’s time to refill.

5. Doctors Office coupons. As odd as it may seem, the doctors office, and pharmacy counter tops, are becoming loaded with coupons. Some have Rx offers, many have OTC medication offers. Look. Skim through the brochures. You might be pleasantly surprised!

6. Regular Checkups For your Rx costs! Prices change constantly. It’s a competitive business. Evaluate your insurance coverage, evaluate the prices at your pharmacy, and don’t be afraid to make changes when it’s best for you and your family.
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OTHER OFFERS TO LOOK FOR:


1. Store Coupons.

In-store pharmacies, chain pharmacies, even warehouse club pharmacies are now offering enticements to keep and bring in new business. Alert shoppers can clip coupons from weekly store sales circulars offering store gift cards of $10 - $25 for new or transferred prescriptions. Check-out coupons, also known as Catalina coupons, for prescription rewards are often provided to loyal store customers.

Even if your insurance does not provide coverage at a specific store, pharmacies are augmenting the customer base by providing coupon incentives for filling your uninsured pet prescriptions at their local store. Safeway brand stores, Target, Rite-Aid, CVS, Kroger, Walgreens, Superfresh…to name but a few…have all jumped on the prescription coupon band wagon.

Some stores, such as CVS, also offer special savings to encourage Medicare recipients to continue shopping at their stores. A recent promotion available to Part D plan holders included a coupon booklet of twelve coupons for $5 off any $20 purchase made within the store.

Check your advertisements regularly, and ask your stores pharmacist what offers are currently available. You might be well rewarded

2. Manufacturer Coupons and Vouchers.

Manufacturers regularly offer coupons and vouchers for relatively new brand name prescription medications, allowing consumers to try the medication for up to one month at no cost. Try before you buy! Coupons for samples, free trial vouchers, even percentage discounts for new customers are available for many medications.

Insurance information is typically not required to fill a sample or trial offer prescription. However, a doctor’s written prescription is required to be submitted with the coupon or voucher.


Once you redeem a trial or other prescription coupon, the manufacturer will generally provide another coupon or rebate voucher by mail. Each time you redeem one, another is provided. With many competing prescription products on the markets, brand loyalty can (and should) be well rewarded.

Even if you are already taking a particular medication, manufacturer offers may be available. Regular “card holder” discounts, manufacturer coupons (also referred to as pharmacy checks), and rebates are increasingly common for brand name prescriptions when a generic alternative is not available but similar, competing, medications are.

Several manufacturers also have “Rewards Programs”, allowing you to submit your receipts for rebates and free gifts. $40 - $200 a year in cash back, as well as free samples and gifts, can add up quickly to reduce or offset prescription costs.

3. Doctors Office coupons.

As odd as it may seem, the doctors office and pharmacy counters are often cluttered with coupons. Manufacturers want to reach their target customers, and customers are generally found at the doctors office or pharmacy counter! Many have prescription coupon offers, as well as over-the-counter (OTC) product coupons such as Tums and Robitussin. Even grocery manufacturers such as Kraft provide coupons booklets on products for special diets, such as high calcium or low sugar. Look. Skim through the brochures. You might be pleasantly surprised!


Maximize your Savings.

While prescription coupons may or may not effect your out of pocket expenses for medications, there are several ways to achieve additional savings using these coupons.

Ÿ First and foremost, combine store pharmacy offers with any available manufacturers offers to receive the greatest returns.

Ÿ Don’t assume you cannot use prescription coupons with co-payments or insurance plans. Frequently you can. The major exception is when your medications are completely covered by Medicare (some breathing meds, diabetic supplies, etc.); you cannot receive financial gains on federally funded prescriptions. Your pharmacist knows the requirements and is generally very supportive in sorting out any confusion.


Ÿ Many pharmacies and stores honor competitors coupons. This includes pharmacy coupons. If your store circular provides a prescription coupon, but your local store does not have a pharmacy, other pharmacies in your area often will.

Some offers are valid only on “new” prescriptions. However, a “new” prescription is any doctor’s written prescription, even if you are already on the medication. If a pharmacy coupon or offer is available, consider asking your doctor for a new written prescription rather than a refill. Manufacturer offers for free trials, samples, or other “first prescription” coupons and vouchers can usually be applied to any “new” filled prescription.


Other store offers are available only on existing prescriptions transferred from a competing pharmacy. For transferred prescriptions, there are several things to consider. First, check whether or not the store accepts your insurance plan. If not, or if you do not have insurance, evaluate the price of the prescription at that store. Paying twice as much for a medication just to receive a gift card doesn’t make financial sense.


Second, no matter what the pharmacy’s price points are on brand name medications, the cost of generic medications should be similar between stores. You can often fill or transfer a generic or low cost prescription out of pocket and still save using the store coupon and/or manufacturer‘s coupon. Call and ask the price before you transfer, and make sure you are benefiting by the offer.

Also, remember, filling or transferring a prescription at one store does not mean it needs to be filled at that pharmacy in the future. Just take your empty bottle to your preferred pharmacy and have it transferred back when it’s time to refill. It is usually possible to transfer prescriptions repeatedly between pharmacies to take advantage of competing offers, however each consumer should evaluate the practicality and benefits of this.

[cuzisaidso]

Just a few things to add.
1.) A controlled medication (Vicodin, Xanax, etc.) can only be transferred once in many if not all states.
2.) If the federal govt is paying for any part of the prescription then a gift card can not be given. This is called the Anti-kickback Statute. This means Medicaid (or any of it's HMO's) Medicare part B and Medicare part D.

[flash]

Originally Posted by cuzisaidso Just a few things to add. 1.) A controlled medication (Vicodin, Xanax, etc.) can only be transferred once in many if not all states. 2.) If the federal govt is paying for any part of the prescription then a gift card can not be given. This is called the Anti-kickback Statute. This means Medicaid (or any of it's HMO's) Medicare part B and Medicare part D.

Good points. With controlled substances, some cannot even be refilled or transferred, depending on the level of control, and some places absolutely will not refill, and require a new script for every 30 day supply (and it's limited to the "standard" dosage). In my experience patients can "transfer" the prescription, but the doctor must still be contacted for a new Rx to be faxed over. How the store deals with this is up to them.

For medicare/medicaid, quite a few meds are not covered. Again, most controlled substances are not, and depending on the plan, several step/type/etc. are not covered and are eligible.

It's possible to get a "free sample" script, which counts as a new script, and since it doesn't require insurance, the g/cs are issued.

There are loads of loopholes, which I won't get in to. It's not unlike the formula checks; you may not qualify if you are on WIC or assistance, but people do.

[katwoman]

Another loophole:

IF your scripts are covered by Medicare/Medicaid you can elect to buy the script outside of their coverage and pay the market rate. You won't have to do it for all your meds, just the ones you choose. Why is this a plus? Say you're on a generic and the covered price for that is $5. But the pharmacy price to someone with no insurance is $7. Let's also say you have a CVS Q for $25 GC on your new/transferred script. So you pay the $7 AND get the benefit of using the CVS Q!

Of course, you will need a understanding doctor who will not mind writing up all those new scripts.