Low cost pharmacy - the ultimate guide to saving money on your prescriptions
Updated: September 26, 2021
Key takeaways:
There are lots of ways to achieve lower pharmacy costs that people often don’t know about. For instance, Eliquis, a common cardiovascular medication, can cost over $300 per month even with insurance. The tips in the article could save you 50% or more per month!
If you only have a moment for this article, here are some quick steps that will typically lead to low pharmacy and medication costs.
- Are there generic alternatives for any of the brand medications you take? Ask your doctor about this - generic prescriptions are usually much less expensive.
- Is there a manufacturer’s discount card for any brands? Check that this is cheaper than your insurance copay and if you qualify. Google your medication name and “discount card” to see if one exists.
- For any expensive medications you take, if it’s possible to double the dosage of that medication, consider splitting pills. Ask your doctor about if this is a safe and effective choice, and check that this would significantly reduce your out-of-pocket cost.
- If you are an Amazon Prime member, look at Amazon Pharmacy. Check that this is cheaper than your insurance copay. It sometimes is.
- If you are not an Amazon Prime member, look at Ro Pharmacy. In particular, look at 180 day and 360 day supply costs. Check that this is cheaper than your insurance copay.
More in-depth methods, which can achieve maximum low cost pharmacy and prescription costs are provided below.
Note: generally applicable tips are listed first and tips specifically for those with Medicare are listed at the bottom.
1) Do you need the prescription?
This one may state the obvious. However, frequently we can be prescribed for medications that are not necessary. Ask your doctor whether you can stop taking any of your medications, especially ones which may have been prescribed from other doctors, or have not been reviewed in a while to determine if they are still relevant.
2) Request an exact quantity of medication from your doctor or prescriber
Especially for conditions requiring medication only for weeks or months, receiving more medication quantity than you need is a waste of your money. A good example is a short course antibiotic which may only have a week or two treatment, yet the prescription is for a month. You will likely pay extra out of pocket for that medication you don’t need. Doctors or prescribers frequently do not think about your out-of-pocket cost, but they should be happy to write a more exact prescription if you tell them. This will save you money.
3) Are you using the lowest cost pharmacy for your insurance?
Most insurance has certain pharmacies that offer the cheapest copays. Often the preferred mail-order or home delivery pharmacy is the cheapest source on a daily cost basis for the medication. If this is not a good choice for you, it’s important to look at the copays at the in-person or retail pharmacies you’re considering. They may have significantly different copay costs at different pharmacies. For instance, if you have Aetna insurance, CVS pharmacies will likely be cheaper than other pharmacies. This could save you a few dollars, or possibly tens to hundreds of dollars per month if you’re using an out-of-network pharmacy. Most health insurance have a website to view what the copays are at various locations for your specific medications.
4) Have you considered 90 day (or longer) medication supplies?
Most medications offer the ability to receive them in 90-day supplies versus the typical 30-day supply. Typically, the per-day cost of the medication dispensed as a 90-day supply is often over 25% cheaper than a medication dispensed as a 30-day supply. Choosing this option does not make sense if you do not expect to use the full supply, such as if your medications or dosages are changing. 90-day supplies are offered both by mail-order pharmacies and traditional in-person pharmacies, such as CVS, Walgreens, Walmart, and major supermarkets. Insurance frequently limits supplies to 90 days, but Amazon Pharmacy and Ro Pharmacy (described in more detail below) may offer 180 days or 360 day supplies which may be the cheapest low cost pharmacy option.
5) Can you find the medication cheaper through non-insurance avenues?
Note: These tips may be relevant for anyone (those with health insurance or without). Aside from the Manufacturer Discount Cards described below, meaningful savings opportunities are typically only on generic medications.
i) Cash price directly from Ro Pharmacy, Amazon, Costco, or Walmart
Ro Pharmacy: Ro Pharmacy is a online-presence mail-order pharmacy specifically for generic medications. Ro Pharmacy offers over 1,000 medications at cash prices (that do not require insurance). Free 2-day shipping is standard. Importantly, unlike Amazon or Costco, no paid membership is required. If you are not already a member of Amazon or Costco, this will likely make Ro Pharmacy cheaper than those two options. Ro Pharmacy is frequently cheaper than Walmart’s $4 prescription program. One other difference is that Ro Pharmacy frequently offers 12-month (360 day) prescriptions which significantly reduces the price. For instance, a recent cost for a 12-month prescription of Atorvastatin was 50% less expensive than their price for four 90-day prescriptions. As of present publication, none other avenues listed here offer a 12-month prescription. To learn more, visit Ro Pharmacy’s website.
Amazon: Amazon is offering Prime Members discounted medications that can be as little as $1 per month for some common medications. You can search for your medication by name on Amazon’s website and compare the cost with or without insurance. Included is free two-day delivery. Amazon Prime membership is needed to be eligible, which as of 2021 costs $12.99 per month plus taxes. To learn more, visit Amazon’s pharmacy website.
Costco: Costco members can take advantage of purchasing their medications at Costco or participating pharmacies though the Costco Member Prescription Program. Generally, in-store pickup and home delivery are options. As of 2021, Costco membership is $60 per year ($5 per month) for a base membership. To learn more, visit Costco’s Member Prescription Program website.
Walmart: Walmart offers a select list of common medications for $4 for a 30-day supply and $10 for a 90-day supply. This can be combined with Walmart+ benefit which offers free home delivery instead of picking up the medication from a Walmart location. As of 2021, Walmart+ costs $98 for an annual plan or $12.95 for a monthly plan. To learn more about Walmart’s $4 prescriptions, visit Walmart’s $4 prescription website. To learn more about the Walmart+ Pharmacy Program, visit the Walmart+ Pharmacy website.
ii) Cash price using coupon programs like GoodRx
GoodRx: GoodRx’s website is easy to use to determine the cash-pay price. Once you type in the medication you can choose a pharmacy and print a coupon for a cash pay price. As of this article’s publication, GoodRx prices are frequently good value, but typically not as low cost as direct cash-pay prices from Amazon or Ro Pharmacy. To learn more, visit the GoodRx website.
Other discount card or coupon programs: there are other discount programs like SingleCare or WellRx. These programs typically offer a similar level of discount as GoodRx.
iii) Manufacturer Discount card (also known as Copay cards or Savings Cards)
The medication manufacturer may offer a discount or savings program on your copays which can save you a significant amount of money, even compared to your copay. For instance, the company that produces Eliquis, a popular cardiovascular drug, offers a $10 copay card that can be used for up to two years. Sometimes you must qualify for these programs and submit an application. The benefits can be large: frequently the copays for Eliquis or other brand medications are more than $40 per prescription and can cost over $500 per prescription without insurance. To find these programs, Google your medication name and “discount card” or “copay card” to see if one exists.
6) Consider splitting pills or tablets
Medications frequently come in various dosages such as 10mg, 20mg, or 40mg for the same medication. Often the cost of the medication for the different dosages is the same for the same pill quantity. If you are on a lower dosage of the medication, you can split the pills of the higher dosage and potentially reduce your cost by 50%. There are tools such as this inexpensive and highly-rated pill cutter that can make the pill splitting easier. It may be inappropriate or dangerous to split certain medications such as coated pills, time release medications, or medications in which the dosage needs to be exact. Please consult your doctor or prescriber before considering splitting your medications.
7) Check if your medication or condition has a pharmaceutical assistance program
There are foundations or not-for-profit groups which can provide financial support for your medication. Typically they use the methods of a copay card to use at your pharmacy, reimbursement, or through free medication. The copay card acts like secondary insurance that can reduce your copays beyond what your insurance covers. Unlike other drug discount cards, it is possible to combine these cards with Medicare or Medicaid insurance. Some groups will provide reimbursement after you submit a form with information about your prescription, and then they send you a check or some other payment. Finally, some foundations have affiliations with the pharmaceutical manufacturers themselves and can provide free medication if you qualify, and typically this free medication is for a limited time, such as for a year.
A good resource, regardless of whether you have Medicare or not, is available on the Medicare.gov Pharmaceutical Assistance Program site. This website organizes assistance programs by specific medications.
Pan Foundation is a particularly well known resource that provides financial assistance for over 70 types of health conditions.
Additionally, there is a service called Prescription Hope which helps facilitate and navigate the process of receiving pharmaceutical assistance program support. They charge $50 per month to handle the details of receiving medication through a pharmaceutical assistance program. There are both positive and negative reviews publicly about Prescription Hope. To learn more, visit Prescription Hope's website.
An overall good way to find these resources is to use Google or another search engine to search for your condition or medication name combined with “copay assistance” or “financial assistance”.
8) Is a different medication cheaper?
i) based on considering your insurance's formulary prices
Your insurance determines your standard copays based on a drug formulary, which is effectively a copay price list. This is almost always published by your health plan and available to view. Frequently the formulary will offer lower copays for certain medications than others that treat the same issue. An example is that for treating psoriasis and psoriatic arthritis, some health insurance plans took Cosentyx off of their formularies in 2021 in favor of another medication Taltz. This means that Cosentyx would no longer be covered by insurance, and the out-of-pocket cost would be much higher. Unfortunately, sometimes the medications favored with lower copays are not exactly the same therapeutically. For instance, they may not work as well for you or have additional side effects. However, sometimes there may be good alternatives to switch medications to reduce your copays. Looking at the favored alternative medications with your medical professional is the best way to evaluate this as a possible way to save money on your copays.
ii) using a low cost generic version
A generic medication is a medication which has the same chemical substance that a branded product does. Generics can come to market once the patent has expired on the branded medication. An example for a non-prescription medication is Advil which can be compared to Ibuprofen that pharmacies frequently sell under one or several labels. For instance, Walmart has Ibuprofen sold under the Equate label that is usually 60% cheaper than the comparable package of Advil. The same situation usually exists for prescription medications. While your medical professional or medication prescriber usually knows to prescribe a generic version of a medication to save you money, there are circumstances in which this does not occur. Sometimes people may request the branded version of the medication even when a generic version exists. The generic alternative should typically offer the same therapeutic benefit as the branded version. Making the switch to the generic alternative could offer significant savings on your out-of-pocket costs. Your medical professional can advise you if this is a good opportunity to get the medication you need while saving money in the process.
Are you Medicare Eligible? If yes, see below.
9) Pick a Medicare drug plan with the lowest drug costs
When selecting a Medicare plan, there is a helpful Medicare Plan finder. It enables you to find a stand-alone Part D drug plan or a Medicare Advantage plan which includes the drug plan. Once you enter your prescriptions and local pharmacies it will show the options along with your out of pocket costs for the year to fill your prescriptions. There is also an option for mail order which is often the cheapest option, although mail order does have drawbacks including not offering as much flexibility if your medications change frequently because mail order typically provides 90 day supplies. When choosing a health plan, you will have to bear in mind the costs of your other healthcare and the other features that the health plan offers, such as the breadth of doctor and provider network, telehealth, and over-the-counter product benefits. You will be able to see the breakdown of your out-of-pocket costs by drug. This is important because each drug has different out of pocket costs based on the drug plan formulary which establishes the copay amount. It’s worth noting in particular that higher tier formulary drugs will cost more out of pocket (such as over $40 for a particular drug’s 30 day supply), and that some drugs are not covered on a particular drug plan formulary and that you will be responsible for 100% of the medication cost because the drug plan will not cover any of the cost. As you can probably realize, these types of medications can disproportionately affect your out of pocket cost, and so good choices if you take one of these expensive out-of-pocket cost medications is either to find a health plan which has these medications on the formulary in which the out-of-pocket cost is reasonable, or to use an alternative cost-saving method mentioned in this article.
10) Ensure you are getting Extra Help for Medicare if you are eligible
If you qualify for Extra Help, which is a financial assistance program, you may pay less or nothing for your health plan monthly premiums and your medication copays. For 2021 Extra Help causes your copays to be no more than $3.70 for generic medications and $9.20 for brand medications. You can qualify for Extra Help if you have less than $19,320 in annual income ($26,130 for a married couple) and less than $14,790 in assets ($29,520 for a married couple). Additional information on receiving extra help is here on the Medicare.gov website.
If you are already receiving Medicaid benefits, you’ll automatically qualify for Extra Help. To apply for Extra Help, the application through Social Security is here.
Important tip if you receive extra help: get all of your recurring medication supplies for 90-day supplies instead of 30-day supplies? The maximum copays of $3.70 for generic medications and $9.20 for brand medications will still apply. In other words, you may be able to reduce your copays by 67% by doing this!
11) Be considerate of the Medicare Coverage Gap
If you have expensive medications, you may need to be considerate of the Coverage Gap. If the total spend on the medications you have used your Medicare Advantage or Medicare Part D insurance on reaches $4,130 (the 2021 amount), your copays will typically become 25% of the total medication cost. For example, if you fill a brand medication which costs $400 for a 30-day supply, let’s say your copays are $50 once you meet your deductible. (Note: in this case your health insurance pays the remaining $350.) If you enter the Coverage Gap, your copays would generally increase to $100 (or 25%). Your insurance, by Medicare standards, would cover less. Only until your out-of-pocket spend reaches $6,550 (the 2021 amount), would you exit the Coverage Gap and begin paying a lower amount. At the end of the calendar year, the Coverage Gap calculation resets, and you begin the new year with your standard deductible or initial copay amounts.
How can you address this situation? There are several potential techniques (some already listed in this article) that you can use to reduce your copays.
- Ask your doctor if it’s possible to change your medications to a less expensive one. An expensive brand medication is typically the primary contributor to reaching the Coverage Gap. Some people are able to switch this medication to a less costly one, such as a generic. For instance, some people will use an expensive brand medication up until the Coverage Gap begins, or sometimes switch permanently to avoid hitting the Coverage Gap altogether.
- Ensure you are getting Extra Help (see above) if you qualify. Those receiving Extra Help do not experience copay increases during the Coverage Gap.
- Look at using a drug discount program, like GoodRx (see below). Particularly on generic medications which have copays, it’s possible these cash discount programs are less expensive than your Medicare Advantage or Part D copays in the Coverage Gap.
- See if the other cost-saving methods listed here are applicable.
12) Check if you live in a State that offers pharmaceutical assistance program
A number of states offer pharmaceutical assistance program to help residents pay for their prescription drugs. (Note: this is separate from the aforementioned pharmaceutical assistance programs.) These programs generally coordinate with the Medicare Part D drug benefit. A good resource to see if there is an applicable program is the Medicare.gov state program finder.
Disclaimer: the information provided on PiggybankRx is for information purposes only and is not designed to replace the guidance, recommendations, or information from a medical professional. Please check with your medical professional before making any changes to your medical treatments or medications. PiggybankRx does not specifically recommend or support any particular treatment or source to receive treatment or products, including particular prescription drugs or pharmacies.