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What to Do When Insurance Won’t Cover All of Your Meds

By , June 14th, 2018 | No Comments

Insurance Won't Cover All of Your Meds

You’ve probably already experienced challenges getting your insurance to cover all of your meds. You might face higher out-of-pocket costs on a medication you really need because:

  • The doctor prescribed a brand that is not covered by your insurance
  • You’re at a pharmacy that’s outside of your network
  • Your doctor prescribed something your plan doesn’t cover
  • Your overall insurance coverage has lapsed

Here’s what you can do to try to bring down your out-of-pocket costs for prescriptions.

Ask Doc for Samples

Many drug companies give doctors product samples they can give to patients at no cost, and all you have to do to get them is ask. Samples temporarily fill your need while you seek a permanent solution.

Request the Generic

Usually the pharmacy will let you know if a generic version is available but you can also request it from your doctor. Generics can cost up to 80 percent less than the brand name version.

Switch Insurance

If your current insurance policy falls short of covering you sufficiently, switch to something that does. Shop around for a plan with more coverage of prescriptions, lower deductibles or less of a difference between in-network and out-of-network coverage. First look for different choices offered by your current plan provider; and if the numbers don’t pencil out to your liking, check out your state’s health insurance marketplace.

Another option worth investigating is Medicaid. It’s jointly by the federal and state governments to assist low income and needy people. Contact your local agency to find out whether you qualify and whether it covers your desired medication.

Look at Other Pharmacies

Even with insurance picking up most of the tab, you might find different out-of-pocket prices for the same medication at a different pharmacy. So it makes sense to shop around.

Prescription Assistance Programs

You can get additional help from non-profit organizations that subsidize out-of-pocket expenses for prescriptions and other health care. Two of the most popular are:

  • FreeDrugCard.us — This is a free coupon card that provides savings of up to 90 percent at major pharmacies across the country, including Walgreens, CVS, Walmart, Rite Aid, Kroger, Kmart, and Safeway.
  • NeedyMeds.org — This website proves a list of assistance programs with phone numbers and links to required paperwork for each drug entered.

Even if your out-of-pocket costs gets prohibitive, the solution isn’t to skip taking the medication altogether — endangering your health means incurring even greater medical expenses. Instead, try to find a solution from among those presented here.

Readers, what have been your biggest out-of-pocket medical expenses — and what did you do to get them taken care of?

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