Mar. 22, 2014 — -- intro: Open enrollment for Marketplace health insurance plans ends on March 31. As that date rapidly approaches, many Americans are shopping for a high-quality, affordable health plan. But the quest for affordable medical care does not end on April 1. There are several steps you can take to reduce out-of-pocket costs during the year. The average American spends nearly $1,000 per year on pharmaceuticals. Consult these five tips to help reduce the cost of your prescriptions without sacrificing your health.
quicklist:title: Consult With Your Doctortext: The high out-of-pocket cost of prescription drugs often hinders patient compliance. One NerdWallet Health study estimated that 25 million adults (ages 19-64) did not take their prescription drugs as indicated in 2013, including skipping doses, taking less medicine than prescribed or delaying a refill.
There is no way of measuring the exact effect of noncompliance on health outcomes, but under-treating or failing to treat a medical condition can lead to serious consequences. If there is a chance you may not be able to afford necessary prescription medication, you should talk to your doctor to figure out a workaround. He or she may be able to provide additional options, such as generics. In addition, your doctor can help you to apply for patient assistance programs offered by pharmaceutical companies, through which you'll be able to get discounted or free medications.
quicklist:title: Check Your Plan's Formularytext:
A formulary is a list of drugs that are covered under your health insurance plan. Under the Affordable Care Act, every plan must offer prescription drugs, but states are allowed to set their own formulary -- so coverage may differ geographically.
Request your health plan's formulary to see if your prescription is covered. When doing so, make sure you have the following information: the medicine's exact name, the dose you take and how many pills your doctor usually prescribes.
If your prescription is not covered, you can request that your plan be amended to cover the necessary drug. Again, communicate with your doctor during this process, as he or she will be able to support the medical necessity of the prescription. You will have the right to appeal if denied.
quicklist:title: Shop Around for the Best Pricestext:
Don't assume that your prescriptions will cost the same at every pharmacy. You can go to your local pharmacies to price compare, or use sites like GoodRx, which allows you to compare prices for all FDA-approved prescription drugs at pharmacies across the country before you buy.
quicklist:title: Ask for Samplestext:
The average physician received $21,000 per year in samples from pharmaceutical companies, according to one 2004 study. The result of this is that many physicians have cabinets full of samples. All you have to do is ask for them. Samples are a great way to test your tolerance to a drug before committing to the cost of a three-month prescription.
quicklist:title: Review Your Medicare Part D Plantext:
You don't need to sign up for Medicare each year, but during open enrollment (Oct. 15-Dec. 7), subscribers can review their options and make changes to their Part D plans. Part D plans add prescription drug coverage to original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans and Medicare Medical Savings Account Plans for an additional charge.
If you are able to anticipate your prescription drug requirements for the coming year, take some extra time to review your options and change your plan accordingly. You may be able to save a lot of money.
Any opinions expressed in this column are solely those of the author.
Fisayo Ositelu writes for NerdWallet Health, a website that empowers consumers to find high-quality, affordable health care and insurance.