Maximizing your prescription benefits

It is important for you to understand how your prescription plan works. Which prescription drugs you take and how you fill them impact your out-of-pocket cost. As the cost of medical care continues to increase, being better informed about your plan will help keep it affordable.

$ Generic
$ Preferred
$$ Nonpreferred
$$ Specialty
Generic drugs are copies of brand-name drugs. In other words, their pharmacological effects are the same as those of their brand-name counterparts.
Preferred drugs may not be available in generic form but are chosen for their cost effectiveness compared with alternatives. Your cost share will be higher than generics but less than nonpreferred drugs.
Nonpreferred drugs are brand-name drugs that are not typically included on the plan’s formulary list. You will pay more for these drugs.
Specialty drugs are typically far more expensive than other drug types. They are prescribed for complex and chronic conditions and are typically ordered through a specialty pharmacy.

Where to fill your prescriptions

Retail pharmacy: This is a pharmacy acting as a retail store to sell prescription drugs to patients. Think of pharmacies like CVS or Walgreens.

Mail-order pharmacy: You can have ongoing medications mailed right to your home versus having to go to a retail pharmacy. You may also be able to set up a three-month supply of your medication.

Specialty pharmacy: Some medications are filled through a specialty pharmacy because they need special handling and monitoring.

How to save on prescription drugs

There’s no question that prescription drugs can be costly even when they’re covered by your prescription drug plan. Here are some tips on how you can save money without putting your health at risk:

  • Start with generic. See if you can start with a generic drug first or discuss your options.
  • Check the plan formulary. If your drugs aren’t listed, ask your doctor for a similar drug your plan will cover. Formularies can change throughout the year. If you are impacted by a formulary change, your insurer will send you advance notice. Review the current formulary list or contact your plan to find out if your medication is covered.
  • Are you in-network? Try to have prescriptions filled at pharmacies that are in-network. Check with your plan to find an in-network pharmacy.
  • Use a mail-order pharmacy for drugs you take on a regular basis. You may be able to save money when you use a mail-order pharmacy for medications you take on an ongoing basis. Your prescription drugs will be sent directly to you by mail.
  • Talk with your doctor. If you find it difficult to manage the cost of your prescription drugs, ask your doctor about alternative medications that may cost less.

Sources:

inc.com/marcel-schwantes/mark-cuban-says-living-a-successful-life-comes-down-to-1-simple-habit/91193789

forbes.com/sites/darrenshimkus/2019/08/07/how-investing-in-yourself-today-will-set-you-up-for-career-success-tomorrow/

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