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Tips to Avoid Pharmacy Frustrations

By on February 28, 2014

Nearing the end of the first quarter of the new year, brings possible changes to your prescription insurance coverage.

Whether it’s a change in your yearly coverage deductible or the out of pocket expense of your current medication(s), there is the possibility of change. However, the shock of these changes, if any, might not be a surprise if you are well prepared. In this article, there are tips that could be used to help prepare you for those changes and calm frustrations.

Tip 1:  Know your insurance coverage carrier and important phone numbers.

  • Direct any specific questions, whether co-pay amount or actual coverage of a particular medication, to your insurance carrier.  They will be able to give you detailed information pertaining to your plan.

Tip 2: Know your deductible.

  • This is VERY important to know. If your insurance plan has a deductible, call your insurance carrier or research the deductible amount and how it will affect the monthly co-pay(s) of your medication(s). Also, ask how it will be paid to them. Whether you are responsible for the full or partial amount of medication before the deductible is satisfied, this is important to know.

Tip 3: Be careful of cost when requesting “BRAND NAME “drugs,  when generic brands are available.

  • If a BRAND NAME drug has a generic, your insurance coverage may prefer the generic. If you choose to continue to fill the BRAND NAME, without proper authorization, you may incur an additional co-pay cost.

Tip 4: Am I eligible for a 90-day supply? If so, is it more affordable through Mail Order or Retail Pharmacy?

  • Call your insurance carrier and inquire if your plan allows a 90-day supply, whether at a retail pharmacy or by mail order, as this could potentially save you money throughout the year. Sometimes, retail pharmacy may only allow a 30-day supply, but mail order may allow a 90-day supply. Before filling your next prescription, call your prescription insurance carrier and inquire.

Knowing these few tips will not only calm some of the frustrations during your “first of the year” prescription fills, but will allow you to become more savvy and potentially save you money. Remember to ALWAYS call your insurance company with specific coverage questions.

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Dr. Cedric L. Salone, Pharm.D., MPH is a residency trained pharmacist and currently works as a  Clinical Pharmacist Program Specialist at the Edward J. Hines VA Hospital in metro Chicago.

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