How not to go broke buying prescription drugs
Prescription drug-related costs are often so high that peoples' household budgets are stretched. So stretched that some of them have to file for bankruptcy, particularly if they have other medical expenses.
But experts say there's a slew of strategies available to ease the debt load and stay out of bankruptcy court. Here are a few of their money-saving tips when trying to fill that prescription.
Avoid using credit cards that carry balances month-to-month. "Don't put it on plastic, because you've just added 25 percent to that bill," said Mark Rukavina, founder of Community Health Advisors, which consults with hospitals on financial assistance, billing and debt-collecting practices.
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Fight for your rights. Make sure you are compensated for any reimbursement from insurance that you are entitled to, and appeal any denial of reimbursement if you believe the plan should have covered the benefit.
"The squeaky wheel gets the grease," Rukavina said. "Look at your contract, look at the information you've gotten from your insurance provider, and if you've got any question, raise it with them. If there's a formal process of appealing claims, pursue that, and it doesn't hurt to cc: your attorney general in a letter if it doesn't seem to be going anywhere."
"Don't take a general answer from a customer-service person on the other end of a 1-800 number as a definitive (answer)," Rukavina said.
Reach out for assistance. Rukavina also suggests patients seek help. He noted that "many hospitals have financial assistance programs or charity-care programs" and patients can always ask their hospital or doctor for a discount on prices.
"That's a surprising thing to many people, that medical bills are negotiable," he said.
Relief also can come from pharmaceutical manufacturers, who have financial assistance programs as well, which are usually income-based, he said.
"There's a whole network of organizations out there that will help people with their co-payments, and those are usually income-based as well," Rukavina said.
Apply for Medicaid. People should check to see if their income qualifies them for Medicaid, the government-run health program for low-income people. The Affordable Care Act allowed all states to expand their Medicaid eligibility requirements to capture nearly all poor adults, and 26 states have either done so, or are in the process of doing so.
"Many times, Medicaid will pay retroactively for certain services," Rukavina said.
Don't forget generics. Also don't forget to consider other ways to lower your drug costs, such as switching from a brand-name medication to less expensive generic versions of the same drug, or "moving from retail to mail-order" purchasing of drugs.
Mitch Rothschild, the CEO of Vitals, a company that among other things helps health plans give their members access to cost and quality transparency tools, encourages people to sign up for services that alert them to sales on drugs.
"We do outbound communications with members about ways they can save," Rothschild said. "Seventy percent of those alerts are pharmacy-related, and the savings are north of $400 per alert on an annualized basis. We're talking real money."