Medical

How to Save Money on Prescription Medication

August 13, 2019 By Kathryn Vercillo Leave a Comment

I’ve seen some tragic situations over the years when people can’t afford their meds. For example, I’ve met organ transplant patients who couldn’t pay for their anti-rejection drugs and ended up losing the organ they had struggled so hard to receive. I, myself, have dealt with some terrible withdrawal symptoms when I couldn’t access my mental health medications. Therefore, I know firsthand how important it is to learn how to save money on prescription medication.

Talk to Professionals to Save Money on Prescription Medication

The first step to take if you’re struggling to pay for your prescription medications is to ask for help. There are several different types of professionals that you can talk to about how to save money on prescription medication.

Talk to Your Doctor

Your first line of defense against expensive prescription medication is the person who prescribes the meds. Talk to your doctor. In fact, you may need to talk to multiple doctors: a general doctor, a specialist, a psychiatrist, etc.

Be very upfront with these professionals about how hard it is for you to pay for your prescription medications. Ask them what the options are. Oftentimes, they’ll be able to provide solutions. It might be as simple as changing the prescription to something more affordable that still works for you. Alternatively, they may be able to write a letter explaining to your health insurance why you need that specific medication.

Furthermore, your doctor may be able to offer samples and coupons to help you save money on prescription medication. At the very least, when your doctor knows that you are struggling, you’ll have someone there to help you manage symptoms related to not accessing your medication.

Talk to Your Pharmacist

Your pharmacist is another great resource to help you find ways to save money on prescription medications. They are familiar with all of the meds. They know what type of discounts are available, which insurance covers certain costs, and what generic versions of medications are available.

They may or may not be able to actually offer you a discount. Perhaps they’ll know of certain tricks, such as saving money by getting a 90-day supply instead of a 30-day supply. However, even if they can’t solve the problem, they can often point you in the right direction to find someone who can help.

Ask Your Health Insurance How to Save Money on Prescription Medication

Oftentimes, the biggest problem is that your health insurance doesn’t cover the medication that you need. Or it doesn’t pay very much of the cost. Therefore, you can go straight to your health insurance provider to get help.

If you have the option to visit your health insurance provider in person, then that’s your best bet. If not, then be prepared to wait on the phone for a significant amount of time before you reach the person who can help you. If you are persistent, they are often able to find some resolution.

You may need to discuss getting a different plan with your health insurance provider. Alternatively, they may be able to tell you what some other drug options are to reduce your costs. Then you can take that information back to your doctor to see if those medications would work for you.

Contact the Drug Manufacturer

There are certain prescription medications that are just very expensive. However, the drug manufacturers know that they have customers who can’t afford those high fees. Therefore, they often offer ways to reduce the costs of those medications.

For example, they may offer a discount program. They may provide samples or coupons. You never know unless you ask. Therefore, you should ask.

Find an Advocate

If you have tried all of these different outlets and you still can’t afford your medications, then it’s time to look for an advocate. Your therapist could be an ally in this. If you have a case manager, then they might be able to help. Alternatively, look for a lawyer, a local group, or a friend who has knowledge about how to deal with the prescription medication and health insurance industries. It helps to have someone in your corner who knows the language.

Common Ways to Save Money on Prescription Medication

Talking to professionals is your best route to save money on prescription medication. However, it helps a lot if you know what to ask for. Moreover, there are some things that you can try for yourself. Here are some of the most common ways that people save money on prescription medication:

Change the Medication

When talking to these professionals, find out if you have the option to switch to a more affordable medication. If there is a generic version of the same pill, then try that. If there’s a similar medication that’s cheaper, then try that. Always work with your doctor when switching meds, of course.

Change the Amount of Medication

Sometimes you can save money on prescription medication just by changing the number of pills that you order. A 60-day or 90-day supply may be cheaper per pill than a 30-day supply. Furthermore, it can reduce the number of times you pay a co-pay.

Also, ask about getting a stronger dose that you can split in half. For example, get a prescription for 45 days of a pill that’s twice the strength you need then cut those in half and you have medication for 90 days.

Shop with Coupons

Drug manufacturers offer coupons to reduce the cost of medications. You can also sometimes find other coupons online for various meds. Take a look at what’s out there before you pay full price.

Shop Around with a Tool Like GoodRx

How much you pay for your prescriptions depends on a variety of factors. One of those is the location where you buy the pills. Therefore, you can save money on prescription medication just by shopping around. You can use a comparison shopping tool such as GoodRx to easily find the least expensive option near you for the medications that you need. You may discover that you need to visit a few different pharmacies to get the best price if you have multiple prescriptions. Given the high cost of meds, that can be well worth the effort.

Make Sure You Have the Right Health Insurance

If you haven’t reviewed your health insurance options recently then make sure that you do so. Find out whether you have the right plan in terms of the medications they cover, your co-pays, and your monthly payment. Moreover, see if you qualify for any low-income programs in your area to help you save money on prescription medications. In addition to Medicare/Medicaide, there are often state programs that help pay the premiums and/or co-pays for people with limited income.

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1 in 4 Cancer Survivors Face Financial Hardship

June 7, 2019 By Amanda Blankenship Leave a Comment

One-fourth of cancer survivors under the age of 65 are drowning in medical debt and one-third of them say they’ve stressed about medical expenses at some point in the past. According to the latest Morbidity and Mortality Report, cancer survivors also typically have higher annual out-of-pocket spending for healthcare than those who have never had cancer.

Financial Hardship Hits Survivors Hard

There are approximately 16.9 million cancer survivors living in the United States. The report, which is published each year by the U.S. Centers for Disease Control and Prevention, found financial hardship hits survivors harder than you’d think.

“The population of cancer survivors is growing and many struggle to pay for costs of medical care,” said Donatus Ekwueme, a senior health economist at the CDC. “As a result, some survivors are worried about paying and have problems paying for medical care, and some are even forced to file for bankruptcy.”

The financial burden is only expected to continue to increase in the coming years. Because the number of people diagnosed will increase, so will the financial hardship.

Cancer Survivors Pay Out of Pocket

To construct the report, the CDC, the American Cancer Society, and the National Cancer Institute analyzed data about the out-of-pocket expenses and financial hardships of cancer survivors in the U.S. Those involved in the data analyzed were between the ages of 18 and 64 between 2011 and 2016.

For the average survivor, out-of-pocket spending each year for healthcare was about $1,000. The average American without a history of cancer spends just $622. On top of that, 25.3 percent reported material hardship associated with their diagnosis.

Material hardship, in this case, means ever having to borrow, rack up debt, or file for bankruptcy, as a result of medical costs. Additionally, more than 34 percent report suffering from psychological financial hardship. This means many of them worried about the ability to pay their medical bills and get the treatment they needed.

One-quarter of the individuals involved in the observations also reported struggling and even failing, to pay their medical bills.

More Likely to Seek Follow Up Care

Of course, the care for cancer patients during treatment is exorbitant. However, it also seems cancer patients’ cost of care doesn’t end when they go into remission. Most cancer survivors are more likely to go to the doctor on a regular basis.

In that respect, cancer “seems to be the gift that keeps on giving,” said Dr. Rachel Adams Greenup, a breast cancer surgeon at Duke University.

Greenup, who was involved in the study pointed out, “Cancer survivors, even if they’re cured, they interface with the health care system more frequently — and so it is more costly to them and to the health care system than someone who’s never had cancer. It’s devastating to these patients.”

How Much Cancer Costs

Depending on your diagnosis, treatment could cost between $5,000 (minor skin cancer) to $108,000 (brain cancer). And those figures are only for the first year of treatment. Not to mention, the indirect medical costs like needing the assistance of specialists or complications with their medication.

The cancer survivor’s family takes on a good bit of these medical costs as well. Families are twice as likely to have more than 20 percent of their income taken up with out-of-pocket medical costs.

Insurance vs. No Insurance

Some cancer patients are without insurance. If they are diagnosed without coverage, it can absolutely ruin them financially. Although they spend less altogether, a greater portion of their families’ income than individuals with insurance.

Even survivors who carry insurance reported borrowing money, accruing debt, inability to pay their medical bills, and even filing for bankruptcy.

How to Help

This year, it is predicted that nearly 1.8 million Americans will be diagnosed with cancer. So, how do we help guard cancer survivors from financial hardship?

First, the authors of the report suggest that making health care more affordable will help improve the long-term survival of those who have survived cancer.

Another way to help prevent such tremendous hardship is educating patients by discussing costs before they begin treatments. Doctors play a huge role in providing guidance regarding out-of-pocket expenses with their patients.

It isn’t really surprising that cancer patients face financial hardships. As Dr. Georges Benjamin pointed out, there are other factors to consider as well. “The other thing we know is there is a correlation between health care costs and people’s mental health,” he said. The inability to pay health care bills can increase risk of sadness and depression.

All in all, the best way to cure the financial hardships of those diagnosed with cancer is early detection and prevention. Early detection will lead to easier, less costly treatment and ease the financial burden of the terrible disease.

It should be noted there were some limitations in the CDC report. All data was self-reported. No information was gathered about the stage or types of cancer.

Readers, what do you think about the financial hardships faced by cancer survivors?

5 Benefits to Look For This National Employee Benefits Day

April 2, 2019 By Tamila McDonald Leave a Comment

Today is National Employee Benefits Day — a day to recognize everything professionals do for the workforce and take a closer look at the benefits available ro today’s worker.

In most cases, employees only pay attention to their benefits when they make plan selections or change jobs. But, understanding what is out there is always beneficial. With that in mind, here are five benefits everyone should look for, either in your current job or the next one.

1. Medical and Prescriptions

In most cases, medical and prescription benefits go hand in hand. These plans not only help you control the cost of your healthcare needs, but they can also protect you against financial disaster.

Medical bills are one of the leading reasons for bankruptcy, so having sufficient coverage is a must.

2. Dental Coverage

While these don’t inherently go together, they are usually additional benefits beyond medical and prescription, even if they fall into a similar category.

Although there are ways to get free dental care, it doesn’t usually cover everything. The cost of dental care can be significant without insurance, so many people choose to skip treatments they can’t afford. Dental insurance helps offset these expenses, making your care more affordable. Ultimately, your oral health is important, so finding a job with dental benefits is always a smart move.

3. Vision Benefits

The same goes for vision plans. Whether you currently need corrective eyewear or not, neglecting your vision can have serious consequences. Without insurance, the cost of appointments, glasses, and contacts can add up fast. Plus, numerous conditions can affect the eyes, so you need to keep up with your exams.

Vision insurance makes it easier to stay on top of your overall health, so seek out these benefits when possible.

4. Retirement Plans

Saving for retirement is a must. If your employer offers a retirement plan, then keeping up with this form of savings is a breeze. Usually, you can have the monthly payment taken straight out of your paycheck. And, in some cases, you can get additional funds from an employer match.

Having an employer provide you with a retirement plan can be significantly more convenient than setting up one yourself. Plus, you’ll be much less likely to ignore your retirement savings, ensuring a more stable financial future.

5. Paid Time Off

Everyone has obligations outside of the workplace, and most people experience occasional illness. But, without paid time off, they can be hard to manage. You might struggle to make doctor’s appointments, handle the needs of your children, or simply to recover after getting sick if you can’t get away from work. But, with suitable leave, you can take the time you need without having to sacrifice anything from your paycheck.

What National Employee Benefits Day Is All About

Ultimately, National Employee Benefits Day is a great time to review what you have or what you want from your job. Not every company offers the same benefits, so look closely at their programs to ensure you get everything you need.

Which kinds of employee benefits do you value the most, readers?

Here’s How To Get Help With Your Medical Bills

November 15, 2018 By Amanda Blankenship Leave a Comment

About 26 percent of Americans between the ages of 18 and 64 struggle to pay their medical bills. That is 52 million people who don’t know how they will cover the costs of simply maintaining their health. If you feel like you’re drowning in your medical debt, there are places that help with bills. Let’s take a look.

Places That Help With Bills

Searching for places that will help you pay your medical bills is easier than you’d think. In fact, there are usually quite a few local organizations that will be happy to help you back on your feet. Some will even provide personal financial counseling to ensure you don’t find yourself up to your neck in debt again. Below are a few places you may want to reach out to if you’re having trouble keeping up with medical bills.

Churches

Local churches are known to help people out with just about anything. They will often lend a helping hand with housing, transportation, food, and, on occasion, they will also help you pay medical debt. This usually only applies if you attend the church regularly. However, if you know someone within the church, it is possible to receive some help that way too.

Crisis Assistance Ministry

Not every city has a Crisis Assistance Ministry. However, if your city does, it’s one of the few places that help with bills. Crisis Assistance doesn’t just help you pay bills either. They help you get back on track by providing counseling to ensure that once you have recovered, you don’t end up in the position again. On top of helping with medical bills, they also help with food, transportation, and housing, as well as job placement.

Government Assistance

There are some government programs that can assist you in paying your medical bills. The U.S. government has programs to assist with paying utilities, prescriptions, and telephones. It is important to note, however, that you will need to meet certain criteria to receive this assistance. In most cases, you need to have income 135 percent or less than the federal poverty guidelines.

Salvation Army

Helping meet basic needs is the entire goal behind the Salvation Army. Although they may not be able to help pay your bills in every instance, they are a great organization to reach out to if you are in need.

Local Action Agencies

Most of these are small non-profit organizations that help with paying different bills, food, and basic necessities. These are often like Crisis Assistance or similar organizations. Search for non-profits in your area to see what may be available.

The 2-1-1 Program

United Way offers a 2-1-1 program that helps individuals locate the help they need in their immediate area. This service is available 24 hours a day, seven days a week. Learn more about the 2-1-1 program here.

Final Thoughts

Each of the organizations listed above are places that help with bills, food, transportation, housing, rehabilitation, and more. If you’re ever in need, don’t feel like you are alone. These organizations were put in place to help YOU (and others) when you’re in need. Don’t hesitate to get assistance.

If you’re looking for some additional suggestions and personal finance advice, head on over to the Saving Advice forums.

Medical Marijuana and Medicare Coverage

August 23, 2018 By Tamila McDonald Leave a Comment

As more states embrace the idea of medical marijuana, many Medicare beneficiaries wonder, “Does Medicare pay for medical marijuana?” Often, the question stems from the fact that cannabis is still illegal at the federal level. Medicare is a federal government program.

The Federal Government’s Stance on Medical Marijuana

Marijuana is a Schedule 1 controlled substance. The federal government believes that it has a high potential for abuse. It states that there is no accepted medical treatment that utilizes medical marijuana. Additionally, they assert that there are no accepted safety standards regarding the use of marijuana as a medical treatment.

Additionally, the Food and Drug Administration (FDA), the federal government agency which approves prescription drugs, has not recognized marijuana as a medicine.

Does Medicare Pay For Medical Marijuana?

No. Marijuana is not an approved treatment for any medical condition and not officially classified as a medicine. Therefore, Medicare will not cover medical marijuana, regardless of whether a beneficiary has a prescription.

Is There Any Medical Marijuana Insurance Coverage?

Probably not. Most private insurance companies take the same stance as the federal government in regards to marijuana as a viable treatment option for any medical condition, even if you have a prescription. This means that medical marijuana insurance coverage essentially does not exist.

Are There Any Marijuana-Based Medications?

Yes. The FDA has approved medications such as those containing cannabinoids, which are chemical compounds found in marijuana that can assist with specific health conditions.

For example, Marinol (dronabinol) contains cannabinoids, and often treats severe nausea and vomiting. They are often used with chemotherapy, and to increase the appetites of persons with AIDS.

Epidiolex (cannabidiol) is an oral solution that contains CBD, a chemical substance in marijuana that does not produce the euphoria or intoxication that commonly comes with marijuana use. It is used to treat seizures associated with Dravet syndrome and Lennox-Gastaut syndrome. These are both two severe forms of epilepsy.

Medicare does cover Marinol and Epidiolex through Medicare Part D and Medicare Advantage plans. Many private insurers will offer coverage as well.

Can You Use Medical Marijuana as a Medicare Beneficiary?

If medical marijuana is legal where you live, you may be able to use it even it if you are a Medicare beneficiary. As long as you have a current prescription, you can purchase medical marijuana on your own.

However, any costs associated with the purchase of medical marijuana will not go toward your Medicare prescription drug plan out-of-pocket maximum. This means the financial burden is entirely on your shoulders.

Additionally, since medical marijuana is not legal at the federal level, you cannot claim the cost as a medical expense on your federal income taxes. This is true regardless of whether it is legal in your state.

States also will not allow medical marijuana to count as a medical expense deduction. The majority of states follow federal rules regarding what is deductible, using your federal adjusted gross income as a basis for state income taxes. This means you cannot separately deduct the expense on your state taxes alone.

Is Medical Marijuana Different from Recreational Marijuana?

No. By and large, medical marijuana isn’t different from recreational marijuana in states that have made both legal. Both options come from marijuana plants and feature many of the same chemicals.

However, there can be differences between individual marijuana products. Delta-9-tetrahydrocannabinol (THC) and CBD levels can vary from one strain or product to the next, impacting how “high” a person feels, how much it reduces pain, and similar effects. In states where medical and recreational marijuana are both legal, legislation often requires packaging that identifies how much THC and/or CBD is present. This serves as both a regulatory measure and it helps to inform buyers.

There are factors that may affect illegally purchased marijuana, such as the marijuana you purchase through a local drug dealer. Product purchased on the street may contain other substances, including potentially hazardous ones, or have varying compositions that impact effectiveness.

Ultimately, Medicare and other insurers are not likely to cover medical marijuana unless it is made legal at the federal level and becomes an FDA-approved treatment for specific medical conditions. Until that time, even those with prescriptions will have to manage the costs on their own.

Have you or someone you know ever used medical marijuana? Tell us about it in the comments below.

What You Should Know About Medicare Part D Coverage Changes

August 23, 2018 By Tamila McDonald Leave a Comment

Medicare Part D experiences changes on a regular basis. In most years, premiums can shift, along with deductible caps, and overall coverage.

For 2018, it was estimated that the average monthly premium for Medicare Part D would decline. It’s estimated to fall from $34.70 to $33.50 each month. However, each subscriber may have varying experiences. This is due to cost differences by physical location.

Other noteworthy Medicare Part D changes for 2018 included a slight increase to the deductible caps. The coverage gap narrowed slightly.

Additional changes are expected in 2019 as well. Here’s what you need to know in relation to Medicare Part D coverage for 2019.

Opioid Restrictions

Medicare is putting certain restrictions in place as the opioid crisis continues to cause harm across the nation. The hope is that these restrictions can combat the issue. Beneficiaries at risk of developing addictions, particularly those with a history of addiction, may not have the same level of access to opioids as in previous years.

However, some patients, such as hospice and cancer patients, will not be subject to restrictions.

Cost Reductions

The Centers for Medicare & Medicaid Services (CMS) announced at the end of July that the average basic premium for Medicare Part D is expected to decline in 2019. This marks the second year in a row where a downward shift will occur.

While the exact savings may vary from one beneficiary to the next, the new average monthly premium is expected to be $32.50. The new premium represents a savings of about $1 per month.

While the details are not fully known, some Medicare Part D users will also see lower costs for specific generic drugs. Requirements regarding cost-sharing for some generic prescriptions may shift. This should lead them to be less expensive for the beneficiary.

Deductible Cap Increase

Medicare Part D’s standard initial deductible represents the out-of-pocket expense before the prescription drug plan begins to cover any costs.

The standard initial deductible for 2018 is $405, and will rise to $415 for 2019. Since 2015, this cost has steadily increased. The cost has risen from $320 in 2015 to $360 in 2016. The next increase came in 2017 at $400 and finally reached $405 in 2018.

Formulary Changes

In 2019, there will be more flexibility regarding the substitution of generic medications for brand-name drugs or similar formulary changes. This provides pharmacies with additional options, which may result in the reduction of out-of-pocket costs especially as many generics are less expensive than their brand-name counterpart.

Coverage Gap Narrows

For 2018, the initial coverage limit was $3,750. After reaching this amount, beneficiaries enter the “donut hole,” or a period where their prescription drug costs exceeded the limit.

After reaching the limit, beneficiaries must cover the total costs of their remaining prescription drug costs for the year. This additional cost can be burdensome, until the yearly out-of-pocket maximum is achieved. However, generic drugs do still have a 56 percent discount. This discount is available once the beneficiary enters the donut hole. Brand-name medications also receive a discount.

In 2019, the initial coverage limit will rise to $3,820. This means more prescription drug costs are being covered by Medicare Part D. Additionally, generic drugs will have a discount of 63 percent and brand-name medications will have a 75 percent discount, which represents an increase. This could make affording medications more manageable.

Plus, even though prescriptions drugs are purchased at a lower price while a beneficiary is in the donut hole, they will receive a credit for 95 percent of the medication’s value. That applies to the out-of-pocket maximum in 2019, which may allow the upward limit to be hit more quickly.

Total Out-of-Pocket Maximum Increases

The point where a beneficiary exits the donut hole is set to rise by $100 in 2019. This brings the maximum from $5,000 in 2018 to $5,100 in 2019.

Open enrollment for Medicare Part D begins on October 15, 2018, and runs through December 7, 2018. During that window, current beneficiaries can select a new prescription drug plan. They can look for one that better aligns with their needs and budget. Seniors must also take into account any changes put forth in the updated program.

Have you had any experience with Medicare Part D? If so, tell us about it below in the comments.