Some Alternatives to Prescription Coverage
People without prescription coverage may not be able to afford their prescriptions. However, prescription coverage may help some people, but health insurance companies can take certain prescription drugs off their formulary. Unfortunately, the US Food and Drug Administration (FDA) found, “Only about half of medicines prescribed by health care providers are taken correctly… Reasons why patients may misuse medications can include forgetting to take them, not understanding the directions, and disliking the side effects. But the FDA also says many people stop taking their medicine, skip doses, or delay filling a prescription to save money” (American Cancer Society). Furthermore, Marilyn M. Singleton, “a board-certified anesthesiologist,” states, “seven of ten Americans use prescription drugs, and they overpay for these 23 percent of the time. Patients often aren’t told they could pay less by not using insurance. If the insurance co-pay is higher than the actual cost of the drug, the middlemen (pharmacy benefit mangers) keep the difference” (2018). Patients could look to alternatives to buy their prescription drugs.
Patients could utilize discount plans and programs to purchase their drugs. People could enroll into prescription discount plans, in which they “typically pay a monthly or annual fee and get a card, although some discount plans are available free of charge” and “are offered by drug manufacturers, drug stores and membership organizations like AARP” (“What’s the difference between prescription discount plans and prescription drug insurance?” 2017). The card allows people to get “a certain percentage discount on the cost of the drug” from the pharmacy (“What’s the difference between prescription discount plans and prescription drug insurance?” 2017). Chain pharmacies can offer discount-drug programs for generic drugs which “can be even cheaper than [the patients’] insurance co-payment” (“Discount-drug programs can save you money” 2012).
People could also utilize patient assistance programs from drug companies, their states, and nonprofit groups (“Patient Assistance Programs for Prescription Drugs” 2017 page 1). Drug companies require an application, the applicant’s financial status, and information about his or her prescriptions from his or her doctor (“Patient Assistance Programs for Prescription Drugs” 2017 page 1). Qualified applicants would either receive a shipment of their prescription to their home or get it at their doctor’s office, but “[the applicants or their] doctor will need to place a new order several weeks before the supply runs out” (“Patient Assistance Programs for Prescription Drugs” 2017 page 1). States’ medication assistance programs could differ from each other and “tend to be geared toward the elderly, disabled, or those in financial need. Some programs are for those with specific conditions like HIV/AIDS or end-stage kidney disease. Programs may also coordinate with Medicare benefit plans” (“Patient Assistance Programs for Prescription Drugs” 2017 page 1). Some nonprofit groups that could help people access their prescriptions include Partnership for Prescription Assistance and RxOutreach (“Patient Assistance Programs for Prescription Drugs” 2017 page 1).
Some people may receive inadequate or no coverage for their required prescription drugs. Discount plans and programs and patient assistance programs could help patients afford them.