Financial Questions to Ask Your Doctor When Prescribed a New Medication

life. health. wellness. Financial Questions to Ask Your Doctor When Prescribed a New Medication

By Emily Tolliver, pharmacy intern at Network Health

Starting a new medication can come with a lot of uncertainty and you are likely to have questions about the medication, its side effects and how you should take it. These are all important things to consider. In addition to asking questions about how the medication will work, you should also think about the financial impact.

For those with pharmacy benefits included in their plan, Network Health provides a list of covered prescription drugs called a formulary. The formulary lists the different cost levels, known as tiers, that medications fall into.

Understanding the formulary can help you make cost-effective choices in collaboration with your doctor. To access your health plan’s formulary, visit networkhealth.com/look-up-medications. From there you will select your specific Network Health plan from the drop-down list. Additionally, you can call Network Health’s member experience team at the phone number listed on the back of your ID card with any questions regarding your drug formulary. Being aware of your drug costs and looking for better financial alternatives saves you money on copayments.

In addition to checking your health plan’s formulary, there are a few key questions you may want to ask your doctor before starting a new medication.

1.

Are there lifestyle changes I can make before starting this medication?

Many chronic conditions such as high blood pressure, high cholesterol and diabetes, may be impacted by your lifestyle. Making changes, such as increasing exercise and eating a more balanced diet rich in fruits, vegetables and whole grains, may improve your health and potentially eliminate the need for medications. Asking your doctor about lifestyle recommendations may improve your health and save you money by avoiding adding a medication to your treatment plan.

2. Is there a generic available? Many medications are available in a brand name and generic form. For example, most people are familiar with Tylenol, the name brand of the drug acetaminophen. Although you can go to the store and buy name brand Tylenol, you can also choose to buy a generic version that is often much cheaper. This idea applies to your prescription medications as well. When your doctor prescribes a name brand medication, make sure to ask if a generic is available, as receiving the generic will end up saving you money. In some instances, a generic may not be available for the medication your doctor is prescribing. If this is the case, you may want to ask some of the following questions. 3. Is there an alternative medication I could try first? For most medical conditions, there are multiple medication options available to treat the disease. In some cases, there may be an alternative medication you have not tried yet that is cheaper than the medication your doctor is prescribing. Make sure to consult your drug plan’s formulary and discuss all available treatment options with your doctor to ensure your treatment is effective clinically and financially affordable. 4. Is there a free trial available? Some manufacturers of name brand medications, such as Eliquis, provide a coupon card for a free trial of the medication. In some instances, you may be required to provide information to the manufacturer such as your demographic information, contact information or annual income to receive the free trial offer. Once you have the appropriate billing information, you can bring the card to your preferred pharmacy to have them process the coupon for your free trial of the medication.

5. Is there a prescription assistance program available? Similar to the free trials offered by manufacturers, some drug companies offer prescription assistance programs to help lower or even cover the entire cost of the medication. These programs often require you and your doctor to fill out an application indicating your need for financial assistance. Some companies may also require additional information such as proof of income and proof of insurance. Once you have filled out the application, it will be sent to the drug manufacturer who will determine if you qualify. In addition to talking about prescription assistance with your provider, you can go to rxassist.org to see if your medication has an assistance program available. At Network Health, we want to make sure you receive the best care possible, and this includes being able to afford your medications. If you are unable to take a medication as prescribed due to financial difficulty, it’s important you talk to your doctor to find a better more affordable option.