With commercial insurance.
So first let’s explain what we mean by commercial insurance. Commercial insurance is anything that is not directly government-funded. So Blue Cross/ Blue Shield, Cigna, Aetna, United, etc. are all commercial insurances AS LONG AS they are not Medicare advantage plans. Does that mean that the state blue cross is not commercial? No – if your state agency uses Blue Cross to administer your insurance plan, that is not considered government funded. Non-commercial or government-funded insurances are Medicare, Medicaid, Tricare, and Veteran affairs coverage.
With lobbying from the insurance companies, congress decided that allowing people with government-funded plans to use copay cards given out by the insurance would give those companies unfair advantages over the competition. I personally think that is bunk and that the pharmaceutical companies did not want to have to compete over copays since they already compete with each other over contract costs and rebates. BUT all it really does it shift more cost back onto patients.
Back to savings.
I went home after leaving the doctors office to go online. The pharmacy actually texted me that my inhaler would be over $150. With my old plan, I had to pay cash for my thyroid meds because I take brand name instead of an available generic. (that will be a later article). So, I know that one was typically about $150 for 3 months’ worth. I had reached my deductible but the time I was put on Ozempic last year, so I never had a copay with it, but I know it is a very expensive medication. (It works great for me though).
Nearly all brand name medications have copay cards available that can lower your out of pocket cost of those medications. So, I got online and googled Ozempic copay card. I had to sign up for the pharmaceutical company’s saving program, but it is worth it. Then I was able to print out a copay card that took my copay down to $25 per month.
I did the same for my thyroid medication and got that down to $75 for 3 months’ worth. And my inhaler went down to $10 per month for 3 months or $30 – instead of $150.
I ended up paying nearly the cash price ($68) for my BP med because I have not yet met my deductible but that will go down to $30 for 90 days after that is met.
So, by googling copay cards and filling out online forms so I can print them out, I saved the following.
Ozempic $150 -> $75
Synthroid $150 – > $75
Breo $150 -> $30
450-180= $270 SAVINGS per 3 months x the rest of the year = $1080 per year in savings. (most copay cards are good for the year)
For spending 45 minutes on the computer before I went to the pharmacy.
Now, I know….” Why can’t they just lower the copays to begin with?
That is a good question. The cynic in me wants to say, “because that would make sense”. Between the insurance companies trying to put more and more on patients and the pharmaceutical companies trying to save money, there are so many barriers in place to helping patients. BUT Now you know, with a little work, you can save a lot of money.