Senior customer buying medicine during the pandemic

How Your Insurance Company Can Help You Save Money on Prescriptions

Prescription drugs can get pricey – quickly.

Some drug manufacturers offer copay coupons to help people manage the out-of-pocket costs of a prescription medication.

But there are times when coupons are just a marketing tool to encourage people to switch to certain costlier medications.

That’s why it’s important to work with your health insurance company to save the most money on your prescriptions as possible. At Blue Cross Blue Shield of Michigan and Blue Care Network, we have a team of doctors, pharmacists and experts that research drugs to find the most cost-effective solution for you.

Part of Blue Cross’ strategy is to use drug lists, also known as formularies, with the goal of helping members get the best treatment outcome with the most cost-effective drug. These drug lists are used during step therapy, a program that guides your prescription drug coverage.

For some individuals who require a high-cost drug that does not have a generic alternative, Blue Cross works to secure savings for members to encourage adherence to what the doctor has prescribed:

  • High-Cost Drug Discount Optimization Program, powered by PillarRx: For some high-cost drugs, there are no generic alternatives. For members on these types of medications, Blue Cross offers a high-cost drug discount program managed by PillarRx. The free program connects members to existing manufacturer copayment assistance programs, helping members take advantage of those discounts for high-cost brand-name drugs they’re already taking.

Blue Cross also offers a discount program to help make members’ existing medications more affordable:

  • Drug Adherence Discount Program, powered by Sempre Health: Enrollment in this free program enables Blue Cross members to receive discounts on their medications when they refill your medications regularly as prescribed. The program focuses on certain drugs treating common chronic conditions, and currently involves medicines used to treat diabetes, cardiovascular conditions and respiratory conditions.

However, some drug manufacturers may offer copay coupons in order to lure people to switch to or remain on higher cost, brand-name medications instead of lower cost or generic medications. Coupons are an effective marketing tool used to encourage people to switch to certain prescription drugs that tend to cost more.

Although patients may be paying less out of pocket for costlier drugs at the pharmacy when they use a copay coupon, they may end up paying more for their health care over the long term.

In the end, someone must cover the real cost of higher priced drugs. That typically falls to the insurance company or the self-funded plan providing employer-sponsored benefits. The increased costs often result in higher health care premiums for members. Coupons for commercially insured patients reached an all-time high of $13 billion in 2018, more than double the $6 billion coupon offset in 2014.

If you’re curious about a new drug option, log into your online member account at bcbsm.com or use the Blue Cross mobile app. Go to “My Coverage” and look for the section on prescriptions.

  • On our website, select Price a Drug
  • On the app, go to Express Scripts, and select Price a Medication from the main screen; you may have to scroll down a little

To learn more about the prescription drugs covered by Blue Cross and BCN, members can also review drug lists online here: 2021 Drug Lists | Help Center | bcbsm.com.

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Photo credit: Getty Images

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