By Stacey L. Bradford
IT ISN'T OFTEN we get good news about health-care costs. But a new initiative by Wal-Mart Stores (WMT) is likely to save a lot of folks some money on their prescription drugs.
Recently the retailing giant announced plans to expand its discount drug plan to 27 states. Under the program, Wal-Mart will charge consumers just $4 for more than 300 popular generic medications including amoxicillin and the antidepressant fluoxetine. Experts predict rivals will feel pressure to lower their prices to maintain customers. Indeed, Target (TGT) has already followed suit.
This news is a godsend for the 46 million people uninsured. But even those folks with drug coverage through their health insurance should take note since they could save some money, too. While every company plan will vary, the average employer-sponsored health plan charges a co-payment of $10 for a nonbranded medication, according to the Kaiser Family Foundation, a nonprofit organization that provides information and analysis on health-care issues.
Of course, shopping at Wal-Mart isn't the only way to keep your drug costs low. Here's the scoop on what Wal-Mart is offering along with more money-saving tips for your prescription drug needs.
Of course, shopping at Wal-Mart isn't the only way to keep your drug costs low. Here's the scoop on what Wal-Mart is offering along with more money-saving tips for your prescription drug needs.
Consider Wal-Mart
First, check to see if you live in one of the 27 states. If you don't, check again soon because a Wal-Mart spokesman says the company plans to roll out its discount program to as many states as it can by year's end.
If you do live in one of the "discount" states, check your medications against the $4 generic drug list to see if you can save any money. What if you already have drug coverage through your health insurer? Typically, when you fill a prescription at a pharmacy, you're charged the insurer's co-pay. Regardless of the medication's cost, even if it retails for less. Wal-Mart, however, says it will charge all of its customers just $4 for participating remedies. Just make sure to present your insurance card with your prescription so the retailer can have the medication added to your health records. (Insurance companies keep all of your medication information together so it can troubleshoot drug interaction issues when you fill a new prescription.)
Other Low Priced Options What if your generic isn't on Wal-Mart's list? In general, the cheapest generics are found at wholesale club stores, including Sam's Club and Costco. These discounters typically charge 50% less for nonbranded medications, says Gabriel Levitt of PharmacyChecker.com, a web site that monitors prescription-drug costs. While Costco doesn't currently offer one flat fee for its prescriptions, the company says it charges just 3% over its costs for all of its generics. Even better, you don't need a membership card to buy your prescription meds there.
You may also be able to save money by buying your maintenance medications through your insurer's mail-order program, says Mohit Ghose, a spokesman for America's Health Insurance Plans, an industry group based in Washington, D.C. Pharmacy-benefit manager Medco, for example, says its mail-order prices are typically 10% lower than retail. While prices will vary somewhat, Medco's small-business members pay just $10 for a 90-day supply of generic drugs. This is not only a slight savings over Wal-Mart, but it also covers some 2,000 medications.
Other Low Priced Options What if your generic isn't on Wal-Mart's list? In general, the cheapest generics are found at wholesale club stores, including Sam's Club and Costco. These discounters typically charge 50% less for nonbranded medications, says Gabriel Levitt of PharmacyChecker.com, a web site that monitors prescription-drug costs. While Costco doesn't currently offer one flat fee for its prescriptions, the company says it charges just 3% over its costs for all of its generics. Even better, you don't need a membership card to buy your prescription meds there.
You may also be able to save money by buying your maintenance medications through your insurer's mail-order program, says Mohit Ghose, a spokesman for America's Health Insurance Plans, an industry group based in Washington, D.C. Pharmacy-benefit manager Medco, for example, says its mail-order prices are typically 10% lower than retail. While prices will vary somewhat, Medco's small-business members pay just $10 for a 90-day supply of generic drugs. This is not only a slight savings over Wal-Mart, but it also covers some 2,000 medications.
Ask for a Generic
Have a medicine cabinet full of name-brand pills? It's time to ask your doctor for the generic equivalents. Indeed, whenever your physician pulls out his prescription pad, ask if there is a nonbranded version of the same drug. (Nearly 75% of all FDA-approved drugs are available as a generic, according to Medco.) If there isn't a nonbranded version, see if there isn't another comparable medication that has a generic alternative, suggests Alwyn Cassil, spokeswoman for the Center for Studying Health Systems Change, a nonpartisan policy research center funded by the Robert Wood Johnson Foundation. Often, there are a handful of medications in the same class that offer similar therapeutic benefits.
Work Within Your Formulary For those times when there is no generic equivalent, try to at least get a prescription for a "preferred" medication. These are name-brand drugs that are on a pharmacy benefit manager's formulary (list of covered drugs) and come at a more reasonable co-payment than a "nonpreferred" drug. While the average co-pay for a preferred drug is $22, the cost rises to $35 for one that's not on the preferred list, according to the Kaiser Family Foundation. Think of it as going to see a doctor that's in-network vs. one's that out of your insurer's network.
Once you have the prescription it may feel like too much of a hassle to call your doctor back and ask for a new medication that's on the preferred list. Better to carry a copy of your insurer's formulary with you to every appointment. This way your physician will have it in front of her when she is prescribing you medicine. You can find the formulary on your insurer's web site.
Use Your Pretax Dollars Even if you manage to successfully tap into a discount-drug program, you can still save more through a Flexible Savings Account (FSA). Flexible spending accounts allow consumers to set aside pretax money for health-care expenses, including prescription drugs.
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Work Within Your Formulary For those times when there is no generic equivalent, try to at least get a prescription for a "preferred" medication. These are name-brand drugs that are on a pharmacy benefit manager's formulary (list of covered drugs) and come at a more reasonable co-payment than a "nonpreferred" drug. While the average co-pay for a preferred drug is $22, the cost rises to $35 for one that's not on the preferred list, according to the Kaiser Family Foundation. Think of it as going to see a doctor that's in-network vs. one's that out of your insurer's network.
Once you have the prescription it may feel like too much of a hassle to call your doctor back and ask for a new medication that's on the preferred list. Better to carry a copy of your insurer's formulary with you to every appointment. This way your physician will have it in front of her when she is prescribing you medicine. You can find the formulary on your insurer's web site.
Use Your Pretax Dollars Even if you manage to successfully tap into a discount-drug program, you can still save more through a Flexible Savings Account (FSA). Flexible spending accounts allow consumers to set aside pretax money for health-care expenses, including prescription drugs.
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Is your profession one that customarily receives holiday tips? Do you have an interesting tipping story or experience? Tell us about it.
You could be featured in a future story.
