In order to get the maximum benefit from your #health-insurance drug plan there are a number of things of which you should be aware. The insurance company is looking to make money. They will always steer you toward the drug that is the least expensive option for them. Generally, this is known as the generic form of the medication. Checking with your doctor to see if he/she thinks the generic will have the same benefits as the brand name drug is wise. I know for example, several doctors who do NOT recommend the generics for certain thyroid diseases. For maximum effectiveness, they would choose Synthroid over the generic version..
Many drug plans will save you a substantial amount if you order the drugs in a larger quantity from a mail order service. When you are in need of a medication long term this can add up to a substantial savings. Typically when you leave the doctor’s office, you are given one prescription. Generally, you rush to your pharmacist because you want to start taking the drug immediately. Ask your doctor for 2 prescriptions, one to take to the drug store and one to send off to the mail order prescription service.
You should also be aware that certain drugs which are covered by your prescription drug plan may only be covered in certain quantities. Again, check with your insurance carrier because the cost difference can be substantial. I recently heard from a friend that his doctor had given him a prescription for 10 pills to be taken over the course of a month. He was told by the drug store that his insurance did not cover this drug. Before going back to the doctor and asking for an alternative medicine he called the insurance company and they told him they did cover the drug but only for 6 tablets a month. The price difference was astounding. Under his plan the drug was $10.00 per pill. Not under the plan the drug was $31.30 per pill. His savings was $127.80 by just making the phone call and getting the 6 pills covered under his plan and the other 4 at the list price.
The disparity in price for the same medication based on whether you have insurance or not is not justifiable in any way other than the drug manufacturers and the insurance companies are in collusion to set a retail price that is not justified by any rational. We the public will continue to be ripped off by this behavior unless we demand that our congressional representatives do something about this abuse. The big drug companies and insurance companies spend millions on lobbyists to protect their interests. We the #Consumer need to make our voices heard.