Cheaper prescriptions may come at a higher price.
Most seniors are careful with managing their money, and prescription drugs offer some wiggle room when trying to find the best deal for their budget. With many older Americans changing their Medicare Part D prescription drug coverage plans at least annually, it’s not uncommon to see requests coming directly from insurance companies to transfer current prescriptions to what they call “preferred pharmacies.”
What Is a Preferred Pharmacy?
As part of a network put together by the insurance company, these pharmacies are usually part of more extensive chains (CVS, Walmart, Walgreens) and are contracted to give a lower price on some prescriptions and goods. The savings can be significant. BlueCross BlueShield of Michigan, for example, lists savings of about $5 for each 30-day supply of generic medication through tier-3 preferred drugs. With many seniors filling between five and 20 prescriptions a month, that’s an opportunity for some savings.
But savings isn’t the only thing to consider when choosing where to get your scripts filled. Here are some things to consider when deciding if a switch will be worth it for you.
1. Your Pharmacist Is an Important Part of the Care Team
As someone who fills and picks up meds for my grandmother weekly, I’ve developed quite a rapport with the weekday pharmacist. He’s familiar with the care plan I’ve designed for her, and he’s quick to anticipate my needs before I even ask. As a caregiver, I can’t imagine switching to a pharmacy and trying to develop a new relationship with someone else. It’s hard enough juggling the responsibilities of raising my kids, so knowing that my pharmacist is an informed teammate who acts proactively to help me with care issues is worth more than the money we would save on cheaper meds.
2. Administration Takes Time
While the advertisements make switching pharmacies seem effortless, the process can be quite complicated. While the new store should be able to handle the transfer of prescriptions on their end, there is still the matter of filling out new paperwork, making sure insurance information is updated, and providing a secure payment method for billing. Some controlled substances (such as pain medications) may need an entirely new prescription to be obtained from the doctor. Mail-order refills can be delayed as they are entered into the new system. Combine that with the frustrations of adding authorized care partners, filling out HIPAA forms, and double-checking dosages, and it may take longer for a loved one with more than a dozen prescriptions.
3. Preferences Matter
In a time when my grandmother can feel removed from the planning of her care, it’s important that her voice is heard when prescriptions are filled. Our pharmacy knows, for example, that she has a tough time swallowing, so they are keen to split 10-milligram pills into two smaller doses and include an extra syringe for oral concoctions. They also know that her budget is stretched. When a recent trial of a new prescription came with an $800 pricetag, they called her in advance and asked if she wanted the entire script filled, or if she would rather pay for part of it and see how it worked. This type of understanding of my grandmother as a person with unique needs is something that we value beyond the savings of a few dollars.
4. Medication Errors Can Kill
We have achieved a delicate balance with my grandmother’s health — one that depends entirely on the perfect dosage of more than 10 medications that don’t always interact well with one another. Having multiple doctors calling in new prescriptions in any given month creates the possibility for dangerous medication errors. Since up to 2 percent of medication refills are estimated to be involved in an error, it’s best to limit your chances of it happening by sticking with a pharmacist you know and trust and who is familiar with your care plan. If you’ve been happy with your pharmacist to this point, and they have been consistently delivering good care and counseling, it’s risky to give that up in the name of savings.
When It’s Worth It
There will be times when the cost-saving opportunities are well worth the switch. A particular tier-4 prescription, for example, may have a savings of hundreds of dollars when filled at the right pharmacy. In the case of needing to switch to preserve the budget, it’s wise to follow this plan to limit errors and ensure a smooth transition:
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Verify that the new pharmacy is still a preferred network by contacting your insurance company directly. (Changes happen frequently. What may have been a savings partner just months ago may no longer be in your network.)
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Allow the new pharmacist to handle the transfers. Be sure to provide your physician’s contact information in cases of renewals or clarification.
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Provide all health insurance, prescription savings club cards, and coupons at the time of the transfer.
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Contact all physicians and hospital systems where there is an active patient profile and notify them of the switch.
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Coordinate prescriptions to be filled around the same time with what pharmacists refer to as “refill synchronization.”
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Ask for counseling when you pick up any medicine for the first time at the new pharmacy (even if you’re familiar with it.) Then, you can ask questions and test the pharmacy’s understanding of the care plan.
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Sign up for text alerts, online account access, or mobile apps that help you stay connected. You can choose to be proactive with changes or updates as they happen.
Remember, most prescription drug plans change annually. What may have been a costly prescription last year might be a candidate for a generic update this year. While it’s unlikely that your loved one will have to go through all of the bureaucracy of changing pharmacies for just one prescription, some chains don’t sell all drugs, and others may charge too high of a premium for them. Do your best to balance the pros and cons of switching, and remember that health of your senior has a value that goes beyond a few dollars in savings.
