Dick Levitt used to spend $1,800 a year in insurance co-payments for the 14 medications he and his wife were taking regularly. Then Levitt, an entrepreneur in Ontario, Calif., got creative. He had his wife ask her doctor for the double-strength version of her blood-pressure drug. With a pill splitter, Levitt cuts the pills in half and gets two months' worth for the price of one. He also fills the prescription through Drugstore.com (DSCM ). Now the Levitts are saving $92 a year just on that one medication and about $600 a year on their total drug bill.
Even people with a prescription plan are suffering sticker shock at the pharmacy. With co-payments for a one-month supply jumping from $10 to $20, or even $50 for some brand-name drugs, and with health plans refusing to cover some drugs altogether, there's a remedy: Shop around.
When filling a prescription in a drug store, always ask what the "cash" price is before you present your insurance card. Many generics cost less than $10 a month, but some plans allow the pharmacy to collect the co-pay anyway. Bypass your plan if the retail price is lower.
If you take the drug regularly, ask for the 90- or 100-pill price. It's often cheaper to buy in bulk out of pocket than to pay the co-pay for each refill. (Insurance companies generally limit you to a 30-day supply per co-pay.) Sav-On Drugs in Los Angeles, for example, charges $10.99 for a 30-day supply of hydrochlorothiazide, a popular blood-pressure remedy. A 60-day supply costs the same $10.99, and 100 tablets are $13.69
You can stretch your co-pay by using a mail-order option. Major insurers, such as Aetna Inc. (AET ) and WellPoint Health Networks Inc. (WLP ), have discount agreements with mail-order pharmacies to send you, say, three months' worth of medication for the equivalent of two monthly co-pays. After you send in the initial prescription, you can order refills via phone or the Internet.
BEWARE OF TV ADS
Check internet pharmacies, too. Costco.com sells that same hydrochlorothiazide at $6.39 for 100 tablets and will ship it free -- and you don't have to be a Costco warehouse club member. Drugstore.com has good prices on generics, and 24-hour on-call pharmacists.
When all else fails, consider switching to a different medication altogether. Health plans put the highest co-pays on many new drugs to encourage consumers to use cheaper alternatives that may be just as effective. Call your plan pharmacist and ask if any of the drugs you take have less expensive substitutes. Then ask your doctor if you can safely switch.
Beware of what's promoted on TV. Some of the most heavily advertised medicines have the highest co-pays because insurers believe they are little more than slightly tweaked versions of older, less pricey drugs. The "purple pill called Nexium" for acid reflux disease could run $50 or more a month through your insurance. But Prilosec, a close relative, sells over the counter for about $20. It's enough to give you heartburn over rising drug prices -- and to send you searching for more reasonably priced options.
By Arlene Weintraub