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Ask the Experts

Prescription Costs—Do I Have Any Control?

Bob Sacks and Doug Terwilliger, NEA Member Benefits

The short and unfortunate answer: very little. But when it comes to prescriptions and hospital fees, there may be some things you can do to keep costs in check. For example:  
  • Buy $4 generic drugs when possible. This is particularly helpful for those facing the huge “donut hole” of Medicare Part D drug plans (by which the government will not cover prescription costs over $1,500 until the patient surpasses $5,100.) Look for the $4 drugs from national pharmacies at the large discount pharmacy chains (e.g., Target Pharmacy).
  • If you are currently treated with brand name drugs, ask the doctor for equivalent generic drugs, which invariably are cheaper and have lower co-pays. Also, many insurers cover or partially cover generic drugs (even in the donut hole of Medicare Part D drug plans). Caution: Some people have found that certain generic drugs, such as those that regulate hormones, are not necessarily equivalent to the brand name. You’ll have to check with your doctor, of course.
  • Want to cut prescription bills in half? Ask the doc to double your dosage—on paper. If the doctor prescribes twice your usual dosage, you can use an inexpensive pill splitter to get the amount you actually need. That way, a 90-day supply will last six months and only require two prescriptions per year. Caution: Dose-critical narcotic pain medicines, time-release, and liquid gel capsules should never be split. It’s up to your doctor whether he or she can prescribe a double dose for you.
  • Ask for free samples.
  • Always closely check hospital bills to make sure you were not charged for doctor visits that never occurred or services, tests, medicines, supplies, or equipment that were never received (e.g., duplicate MRIs or X-rays on the same day). According to an ABC News Special Report, over 70 percent of all hospital claims contain errors and overcharges. 

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