By Patricia Prewitt
My Personal Rx Adviser
Topics for this column often come from real-life questions I receive when teaching a consumer education class, or questions from friends or referrals. Recently, a working Mom called with questions about prescription savings options for her adult child still being covered through the family’s commercial insurance.
One of the benefits of the Affordable Care Act is the ability to have offspring remain on the commercial health insurance plan of working parents until turning 26. However, parents do not necessarily have visibility to prescription costs and health records due to HIPPA and privacy laws.
How can I best address complaints about high prescription cost concerns, while respecting the privacy of my son/daughter? They pay for their own prescriptions.
Let them know the internet can be helpful in searching for brand-name copay savings cards. After registering their personal data on the online product portal, most companies will simply text a card with the codes to their mobile phone number or email. While some young adults may balk at the use of coupons, they are usually happy to learn it may save them up $25-$75 or more per prescription.
What if our employer pharmacy benefits require the use of a mail-order pharmacy?
Mail-order pharmacies generally will not accept or process manufacturer copay savings cards. Individuals can still register for a program for high-cost brand-name products. Somewhere on the brand medication’s website will be instructions – likely in tiny text – for participation with a mail-order pharmacy. Follow the instructions to submit proof-of-purchase receipts and paperwork. Once the receipts have been validated, a check will be issued to the recipient for the savings.
It’s a similar process to submitting rebate paperwork for a high-value electronics or appliance purchase. Checks in the mail are good! Allow 4-8 weeks for a rebate check to arrive for the person taking the medication.
What advice would you give to young adults moving off of their parents health insurance plans to find a plan that favorably addresses their prescription needs? Licensed independent health insurance agents can advise young individuals, like they do for people transitioning to Medicare. It is important to choose a plan based on overall needs, including any prescriptions routinely used, not simply the lowest price. The Massachusetts Health Connector, https://www.mahix.org, by the Commonwealth of Massachusetts offers plans for health and dental insurance.
What else? Younger people can qualify for patient assistance for certain expensive brand-name medications. They may be at a lower pay scale, and these programs are worth investigating for access to needed medications when out-of-pocket costs are high.
Content provided is for educational purposes only, and is not intended as a substitute for advice from a qualified medical professional. The opinions expressed within are those of the author.
About the Author: Patricia Prewitt is a local Massachusetts resident who spent more than 30 years in the pharmaceutical industry. Tricia is a consumer education advocate, and loves helping people find ways to save money on their prescriptions. More information and free resources are available on her website at https://mypersonalrxadvisor.com/resources or call her at 508-507-8840. Favorite Quote: “Act as if what you do makes a difference. It does.” – William James
