When you visit your doctor, they prescribe a new medication and tell you it might be an expensive co-pay. So, they give you a manufacturer coupon to bring with you to the pharmacy. When you get to your pharmacy, the coupon works like a charm – you save $30 off of your prescription co-pay. Then, you remember your friend telling you about this amazing discount card that can save you up to 90 percent off your co-pay and ask if you can apply that, too. The pharmacy technician says no, it doesn’t work like that. How do all of these savings programs work? Is there any difference between them?
There are three main types of savings programs you can use – manufacturer coupons, discount savings cards, or patient assistance programs. They all work to save you money in very different ways, and unfortunately, can’t be used together in any way, shape, or form.
Manufacturer coupons are provided by a prescription medication’s manufacturer. Usually when a new drug comes on the market, your copay can be very expensive even using your health insurance. Manufacturers quickly realized a long time ago that a pricey co-pay will typically outweigh a doctor’s strong recommendation for a new drug. Their solution – manufacturer coupons.
These coupons provide a certain dollar amount discount on top of your insurance co-pay (up to a maximum amount) or a decent-sized discount for a cash-paying patient. You can get them at your prescriber’s office and sometimes on the manufacturer’s website. The one downside is that some of these coupons need to be activated (by phone or internet) before getting your prescription filled. Otherwise, you may end up having to spend some extra time and activate your coupon while you’re at the pharmacy.
The second type is the discount savings card. You can get them pretty much anywhere: in your mail, on the internet, etc. You can tell it’s a savings card and not a manufacturer coupon because it won’t be for a specific medication and will be for a percent off. What’s important to know about these cards is that they can only be used in place of your prescription insurance — i.e. it’s either or.
While these discount cards may advertise savings of up to 90 percent off, nine times out of 10, your insurance will have the better co-pay. While a drug might cost you $45 as a co-pay using your insurance, if it costs $900 out-of-pocket and you use your discount savings card up to its maximum potential of 90 percent, you’ll still pay $100. Pretty much the only time it’s the most cost-effective to use these cards is if you don’t have any health insurance.
Patient assistance programs are the final type. These financial aid programs are for a specific, targeted population that’s taking a brand name medication whose manufacturer offers it. If you’re taking the drug, don’t qualify for any type of health insurance (including Medicaid), and meet specific income criteria, you may be able to enroll in one. Depending on how the program is set up and your circumstances, you could get the drug for free or pay a partial amount of a typical co-pay. You will have to submit an application to the program, along with information that confirms what you wrote (pay stub verification, etc.).
Patient assistance programs aren’t very common, though, and a manufacturer usually doesn’t offer them for every brand name drug they make. But, if you are one of those people who truly need help and can apply, these programs are a great resource.
As you can see, depending on the situation and your financial circumstances, you have three various ways to help you save on your prescription copays. Hopefully this explanation eliminates some of the confusion, and no matter what your circumstance in the future, you’ll know which option to use.