Picture this: You’re picking up a prescription from the pharmacy that you’ve taken for years. But, instead of ringing up at the price you’ve paid every other time, the register shows you owe more than double what you previously paid for the same drug — yikes! Thankfully, there are several things you can do if your drug price skyrockets.
Check your formulary
Your drug formulary is a list of prescription drugs, both generic and brand-name, that providers have reviewed for overall value. The overall value of a drug is generally measured by a combination of its safety, effectiveness and cost. Some health plans classify different drugs into tiers based on their overall value, which is why a brand-name drug may be pricier than its generic version.
If you have a Wellmark Blue Cross and Blue Shield health plan, you can view your drug formulary online Opens New Window. Within each formulary list, you can search for your prescriptions by their name or what they're used to treat. Your formulary will then tell you at what level your drug is (or isn’t) covered, if it’s a specialty medication, if it has any quantity or age limits Opens New Window, if it needs prior authorization from your provider, and if it has any brand-name or generic alternatives.
Just like a gallon of milk and a bag of sandwich bread are one price at Target®, another price at Walgreens®, and yet another price at the same stores in a different city, pharmacies don’t always charge the exact same amount for prescription drugs. You can log in to myWellmark® Opens New Window to view your prescription drug coverage. You can use the Check Drug Cost tool in myWellmark® to compare the costs of different drugs at pharmacies in your area, including physical stores or mail-order options, with prescriptions you’ve filled before or new drugs your provider recently prescribed.Quick tip: Switching your prescription to mail-order Opens New Window, which typically provides a 90-day supply, is often cheaper than picking it up at the pharmacy.
Talk to your doctor.
They can guide you to similar or alternative medications that are lower in cost. Usually, a simple phone call with your doctor or their care team can help resolve this for you. If you’ve researched alternatives on your drug formulary ahead of time, you can ask your provider about them — they may or may not recommend them, depending on your situation. Your doctor may also be able to write your prescription for a longer period to help save money on regular copays, depending on your benefits.
Quick tip: If you have a pharmacy home — that is, you always pick up your prescriptions from the same pharmacy and the pharmacists know your medical history — you may be able to ask your pharmacist to substitute a generic drug if your doctor prescribes the brand-name version.
Talk to your pharmacist.
They can also help you identify potential alternatives that you can discuss with your doctor. Your pharmacist may also be able to offer information about opportunities for savings, such as the availability of a generic version or any coupons.
Quick tip: Use the Check Drug Cost tool on myWellmark® to find which nearby pharmacy can offer you the best price for your medication.
Get more from your health plan with myWellmark
- Sign up for mail-order delivery
- Locate in-network pharmacies
- Check your out-of-pocket costs before you head to the doctor or pharmacy
- Keep tabs on your health care spending, including copays, deductibles, and your out-of-pocket maximum
Not registered for myWellmark yet? It’s easy — and free! Sign up today Opens New Window.
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