My late husband took 16 medications a day. Some had low co-pays, and a 3-month supply was only $10 to $20. His most expensive prescription drug was Revatio, which required a co-pay of $1,250 for a 3-month supply. The middle-ground co-pays were on average $300 for a 3-month supply. The total expense was staggering, and only a fraction of his total medical expenses. I managed to buy all of the drugs he needed, but I had to use a variety of methods to do so.
One word of caution, though. When buying meds from multiple sources it’s imperative that you keep an up-to-date, comprehensive drug and supplement list for the patient. I found this was easiest to do electronically, updating a Word document whenever his medications or supplements changed, and saving a copy of each date’s list. I printed a copy of this list and took it to every doctor's appointment, ER visit or therapy session. I also had the pharmacist at the local pharmacy where I filled my husband’s narcotic prescriptions look at it from time to time to be sure there were no conflicts between his meds.
The easiest path is to apply for Extra Help through Medicare. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 states or the District of Columbia. In 2015, you may qualify if you have $17,655 or less in yearly income ($23,895 for a married couple) and $13,640 or less in resources ($27,250 for a married couple). You can apply for the benefit at any time your income and resources change. In 2015, drug costs for most people who qualify are no more than $2.65 for each generic and $6.60 for each brand-name covered drug. (In 2016, costs are no more than $2.95 for each generic and $7.40 for each brand-name covered drug.)
You can apply for Extra Help online here, or you can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply over the phone or to request an application. You can also apply in person at your local Social Security office.
There are state programs to assist with your drug costs as well. Contact your state government for information on Medicare Savings Programs (MSP)—programs in your state that help pay your Medicare premiums, your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, coinsurance, and copayments, and Medicare prescription drug coverage costs.
Some pharmaceutical companies offer assistance programs for the drugs they manufacture. To see if your drug’s manufacturer has an assistance program, visit this site or check out AgingCare's comprehensive Prescription Drug Assistance Program Locator.
There are non-profits that can help uninsured people with their prescription drug costs. One such organization is SCBN Prescription Advocacy. Another option is RXOutreach.
There’s still hope, even if you don’t qualify for an assistance program. Discount warehouses such as BJ’s and Costco consistently offer the lowest prices on drugs. And you don’t have to be a member to shop at their drug stores. You can also negotiate for a lower price with some local, privately-owned drug stores. Don’t be shy about calling around and asking for a lower price on your medication!
There are prescription drug discount cards available at low or no cost, but it’s hit or miss on whether the discounts offered will help with your particular med needs. Still, it’s worth looking into. A savings card just might provide significant discounts on the drugs you need.
And finally, if none of these options are working for you, you can do what many Americans do, and buy your drugs from Canada. I had to resort to this for some of my late husband’s more expensive drugs. The Revatio I mentioned earlier in this blog cost me $550 for a three-month supply when ordered from a Canadian pharmacy, as opposed to the $1,250 co-pay through his Medicare Advantage plan. I bought the generic, and, according to his cardiologist, it was as effective as the brand name. Your first order can take a few weeks to process, so plan ahead if you want to use this option.
Ask your doctor if samples are available to use while you wait for your order to be processed. Another option is to get two prescriptions; one for a one month’s supply at a local pharmacy and one to mail to the Canadian pharmacy. Some pharmacies will expedite your order for a slight surcharge, sometimes as low as $10.
Different pharmacies offer different prices for the same meds, but you can compare prices on PharmacyChecker. This site checks the safety credentials of the online pharmacies they feature and provides online pharmacy ratings to protect American consumers. PharmacyChecker has been recommended by AARP, CBS, The New York Times, NPR, The People's Pharmacy, and more.