Many households with health insurance may not prioritize managing their prescription costs, as they tend to rely on their coverage to handle these expenses. It's a reasonable expectation that their health insurance will adequately cover medication costs, keeping them affordable and accessible.
However, while this mindset can work well for some, it often doesn’t pan out as expected. Because of this, Matthew Herfield, Co-Founder and CEO of BuzzRx, strongly advises all households — including those with health insurance coverage — to take advantage of a free prescription discount card.
As Herfield reveals, pairing health insurance with a BuzzRx prescription discount card is ultimately the best way to ensure prescription expenses don’t become a financial burden.
Navigating the Formulary
For many households with insurance, one of the biggest surprises can come from their insurer’s formulary — the list of drugs that are actually covered under a plan.
“A formulary is a list of medications that your insurer has approved, and these are the drugs that will be covered by your insurance,” Herfield explains. “For example, there are often multiple drugs that can be used to treat the same condition. A formulary may only cover one of these medications. If you treat your condition with a different medication that isn’t listed on the formulary, you’ll either have to pay out of pocket or switch to a drug that is on the formulary.”
While it is possible to get an exception to receive coverage for a drug that isn’t on your insurer’s formulary, the process is lengthy, and there is no guarantee your exception will be approved. Because of this, it is strongly encouraged that households review the insurance formulary to confirm if their prescriptions are even covered in the first place.
Copays, Deductibles, and Coinsurance
Another area where prescription medications can be costlier than expected with insurance depends on your individual plan’s copays, deductibles and coinsurance rates for prescription drugs.
Herfield explains, “Prescription drugs are typically categorized into tiers that influence your out-of-pocket costs, including copays and coinsurance for various medications. For lower-tier generic drugs, you might only pay a copay of $10 or $20. However, specialty brand-name drugs, placed in higher tiers, can still carry significant costs, even with insurance. For those medications, you may face a coinsurance rate of 40%, potentially resulting in hundreds of dollars per fill.”
In addition, some insurance plans only provide drug coverage after members have met their deductible (and some also have special deductibles that apply exclusively to prescription drugs). All medication purchases made before the deductible is met must be paid completely out-of-pocket. For households on high-deductible plans, this could result in thousands of dollars of medical spending before receiving coverage.
HowBuzzRx’s Prescription Savings Service Helps
The potential pitfalls of getting prescription coverage through insurance are why Herfield recommends that all households — regardless of their level of insurance coverage — use the BuzzRx website or app to check for medication savings regularly.
“Our prescription savings service offers you a negotiated, discounted rate at over 60,000 pharmacies nationwide,” he explains. “These discounts can reach up to 80% off the manufacturer’s price, often bringing your costs down to less than what you’d pay with an insurance copay. Simply present your discount coupon to the pharmacist to access the reduced rate. It’s a straightforward and effective solution when insurance doesn’t cover a prescription or if copays and coinsurance are too high.”
BuzzRx’s app and website simplify the process of determining whether the discount card offers greater savings compared to users' insurance policies. The easy-to-use search function allows users to look up their prescriptions and compare discounted prices at local pharmacies. Since the program's discounts are negotiated directly with the pharmacies, prices can vary significantly, creating even more opportunities for savings.
Savvy members can compare available discounted rates with what they would pay out-of-pocket if they used their insurance policy by reviewing their plan’s coverage options. This way, they can arrive at the pharmacy prepared to use the method that will offer the most savings. Alternatively, you can ask your pharmacist to compare your insurance price to the discounted price with BuzzRx to get the best deal.
Households can download the free BuzzRx app to begin receiving prescription discounts or request a physical card by mail. Digital cards can also be printed, texted, or emailed to users, making it easy to save instantly at your local pharmacy.
Maximizing Your Healthcare Savings
“A prescription discount card may not always provide a lower rate than your health insurance, but it often does,” Herfield concludes. “Since obtaining a BuzzRx prescription discount card is free, it’s a smart choice to have one on hand whenever you need it. By selecting the best option for each prescription, you can consistently maximize your out-of-pocket savings.”
While each household’s prescription medication needs and potential savings with a discount card may differ, exploring additional savings options is always a smart strategy.
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