Prescription drugs keep you healthy and may save your life. While your employee benefits probably include a prescription drug benefit, medicines are expensive. Maximize your prescription coverage with 11 tips.
Tips to maximize your prescription coverage
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1. Advocate for generic brands. Generic brands are as safe and effective as brand name drugs, but they often cost one quarter less. Ask your physician to approve the generic form of your medication.
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2. Ask for a preferred brand. If your doctor won’t prescribe generic medicine or the drug is new and has no generic equivalent yet, ask for a preferred brand. It's as effective but a bit more expensive than generic brands.
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3. Discuss alternative medications. Instead of an expensive brand name, your doctor may prescribe a different medicine. It might have different efficacy or side effects but work as well as the more expensive option.
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4. File an appeal. Contact your insurer and file an appeal for approval to take a medication that’s medically necessary but not part of your prescription drug benefit formulary. If your appeal is unsuccessful, contact your state regulator and request a free independent medical review.
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5. Try samples. Your doctor may provide you with samples of medicine before giving you a prescription. Take the samples to see if they work. Then ask for and fill a prescription from your doctor.
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6. Switch to Mail Order. Fill your prescription via a mail order service rather than at a traditional pharmacy. You may save money in the long run.
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7. Refill a 90-day supply. Most medications include a 30-day supply; however, you may receive a better price on a 90-day supply. Talk to your doctor or pharmacist about this option, especially if you take a maintenance medicine that treats a chronic condition like arthritis, asthma, cardiovascular disease, diabetes, or high blood pressure.
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8. Choose a different pharmacy. Shop around for a better price on your medicine. Different pharmacies in your hometown or through mail order may charge less for your medication.
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9. Pay out-of-pocket. While your insurance benefits do help you save money on medicine, ask your pharmacist to compare the cost with and without your insurance. Then decide which option makes the most financial sense.
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10. Apply for financial aid. Several programs help you pay for medicine prescribed by your doctor. Ask your doctor for information or contact the drug maker about financial assistance.
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11. Use a discount program. A discount card may reduce your medication cost. In some cases, the card covers a specific brand or it may offer discounts on several medications. Talk to your pharmacist for details.
Your prescription drug benefit allows you to take the medicine you need.
Learn about ways to lower out‑of‑pocket costs through the Pharmacy Savings Program.
To understand how coverage is administered and exceptions are handled, see Pharmacy Benefits Management (PBM) Coverage.
For additional discount options and member programs, review Pharmacy Health Discount Benefits.
Use these 11 tips to cut your prescription costs.
Frequently Asked Questions
Are generic drugs as safe as brand-name medicines?
Yes; generic drugs contain the same active ingredients and must meet the same safety and quality standards as brand-name medicines.
Will mail order save money on all prescriptions?
Mail order often lowers costs for maintenance medications taken regularly, but compare prices and delivery times before switching.
Is a 90-day supply right for everyone?
A 90-day supply can reduce per-fill costs for stable, long-term medications, but check with your doctor and insurer for appropriateness and coverage rules.
How do discount cards and manufacturer assistance differ?
Discount cards offer reduced retail prices for certain drugs, while manufacturer assistance may provide financial help or copay support for specific branded medications.