Prescription Expenses

Costs associated with prescription medication are one of the most quickly rising and confusing aspects of cancer care. They can be managed. The first step is to understand what your prescription costs will be. Co-pays are a set amount you must pay for a given prescription, such as $20 or $50. Co-insurance is a percentage of the total cost of the prescription that you must pay. More expensive medications have higher co-insurance amounts.

Questions for your pharmacist or health care team
  • Is this medication on my health insurance plan’s formulary or preferred drug list? 
  • What is my co-pay for this prescription medication? 
  • Can we regularly go over my list of medications, to see if there are ways to lower my prescription drug costs?
  • Is there an over-the-counter medicine that has the same effect as the prescribed medication (especially for medications prescribed to manage side effects)? Is it less expensive? 
  • What are the programs offered by pharmaceutical companies and non-profits that can help cover the costs of my prescription(s) for cancer treatment or side effects? 
  • Is this prescription a one-time cost, or will it be an ongoing expense? 
  • Is there a less expensive drug (generic or brand-name) that will be equally as effective? 
Questions for your insurance company representative
  • Are oral chemotherapies covered under my major medical insurance benefit or my prescription drug benefit? 
  • Do I have a mail-order prescription medication option? Would it be less expensive?

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