What to Do If Your Health Insurance Has Lowered Your Monthly Prescription
When you rely on expensive prescriptions, there is little more worrying than your health insurance no longer covers them – and, unfortunately, this happens more often than you might expect. According to new GoodRx data , 15% of Americans have lost at least one prescription in the past year. Fortunately, Consumer Reports advises that there are certain steps you can take if this happens to you.
Talk to your pharmacist
You should start by talking to your pharmacist to find out the facts and to see if they have any recommendations. You can double-check your network pharmacy for the latest information on your insurance to make sure they have not received a duplicate prescription.
There are a couple more options you can ask about: postal order or pay without insurance. Smaller independent pharmacies may offer a lower price if paid in cash. You can also search for discount coupons on sites like BlinkHealth , GoodRx, or RxSaver .
Work with your insurer
Another option is to work with an insurance company. Your doctor can ask for an exception on your behalf; However, this process does not occur immediately. If your coverage is through Healthcare.gov , find out if your insurance company will offer a one-time top-up to give your doctor more time.
You can work with a patient advocate . Consumer Reports says these professionals may charge $ 125 an hour or more, but that could pay off. You can verify their credentials through the Patient Advocacy Certification Board . If you have a Marketplace plan, try talking to your local health insurance agent or broker .
You can also ask if your company is willing to protect you. Your HR plan administrator may have the option to approve prescription coverage or get it through your company broker.
If these options don’t work, you can file a formal appeal with your insurance company or an external review board. Your doctor should take the lead in this process by providing all the necessary documentation.
Seek financial help
After completing the steps above, there are a couple of final options left. These options may not provide a lasting solution, but they may offer some temporary relief until you come up with a better plan. You can look into prescription assistance programs such as needymeds.org or rxassist.org , which may offer income-based discounts. However, there may be a limit to the number of prescriptions you can write or how long you can use the program. You can also look for charity pharmacies. There are 50 pharmacies and nearly 700 charity clinics with pharmacists across the country, and these locations may offer free or reduced prescriptions.