Pharmaceutical companies have programs to help reduce the cost of some expensive drugs, Rosen said. Ask your doctor for samples or coupons, or a co-pay card, Leon said. Check the drug manufacturer’s websites. Ask for generics.
Shaffer said to do a cost comparison to determine the best place to fill a prescription. If you need a 90-day supply, it may be a mail order pharmacy. If it’s an antibiotic, Publix offers certain common ones for free. Walmart and Target also offer $4 prescriptions, regardless of insurance, for certain maintenance drugs.
Kaskel, whose health plan has a $5,000 deductible, asks for the cash prices at pharmacies, and she’s not afraid to shop around. One drug that cost $100 a month elsewhere was only $30 at Walmart, she said. But the large chains don’t always have the best prices.
“I found the local pharmacies are more willing to negotiate a price, and they even deliver,” Kaskel said.
Apps can help you compare costs before you leave the doctor’s office, Shaffer said. The free Florida Blue mobile app for Apple and Android devices allows a patient to input a drug name and find costs at local pharmacies as soon as you’re handed the prescription. That way, if it’s very expensive, you can ask for an alternative on the spot, Shaffer said. “It saves a lot of money, and it saves a lot of time,” she said.
Examine your bill
“People make mistakes. Don’t take anything for granted,” Rosen said. “Look at your bills and your insurance company’s EOB (Explanation of Benefits). They are done in huge volumes in automated processes.”
Shaffer said if you get a bill and don’t understand it, call the billing department for an explanation and to negotiate how you will pay it, and whether you will pay the full amount.
Leon said the last two client issues he resolved involved billing problems. He said common problems include billing issues when a customer is covered by more than one insurance provider, and insurance claim denials by HMO patients who don’t obtain proper referrals.
“The whole process is rife with opportunities for error,” he said. “This is why every doctor’s office has at least one person who does nothing but deal with this stuff.”
If you get a bill that you can’t afford to pay, call the provider immediately to discuss it, Leon said. “A hospital or physician can negotiate,” he said. “If you wait for it to go to collections, the collection people can’t or won’t negotiate.”
There’s no guarantee you’ll get a better deal, Leon said, but people “make amazing deals, sometimes paying over years,” he said.
Some people are used to having fully-featured policies from their employer. If they lose their job and have to buy their own policy, they think buying a fat policy is the only way to go. “They may be paying for more than what they need,” Rosen said. “For example, if you have a young, healthy person getting comprehensive coverage, they may never get the benefit out of it.” A cheaper high-deductible plan, with higher out-of-pocket costs and coverage for catastrophic events, may be less expensive in the long run, he said.
“People should understand what they need, and what their options are,” Rosen said.
Don’t be intimidated by the process, Shaffer said. “The older generation grew up never questioning the doctor,” she said. “Today it does fall on the individual to understand their health needs and the financial implications. … Asking questions is one of the most empowering things a consumer can do.”