Before Medicare Open Enrollment: Take a Closer Look at Your Medications and Prescription Costs
October is a good time to take a closer look at your prescriptions.
Medicare Open Enrollment begins October 15 and continues through December 7, giving Medicare beneficiaries an opportunity to review their health and prescription drug coverage for the coming year.
But before comparing plans and prescription benefits, there is an important first step that is easy to overlook:
Do you know exactly which medications you take, why you take them, and how much they are costing you?
For many patients, especially those managing multiple chronic conditions, the answer may be more complicated than expected.
At Lake Country Medical Group, medication reconciliation is an important part of helping our patients manage their health. It can also uncover opportunities to make medications more affordable.
Your Medication List May Not Be as Simple as You Think
Many patients take several prescription medications along with over-the-counter medicines, vitamins and supplements.
That list can change frequently.
A specialist may prescribe something new. A medication may be changed after an emergency room visit or hospital stay. A prescription may be discontinued but remain on an old medication list. Two providers may prescribe medications that serve similar purposes.
Over time, it can become surprisingly difficult to keep everything straight.
That is why medication reconciliation is so important.
Medication reconciliation involves reviewing your complete medication list to help confirm:
- What medications you are currently taking
- The correct dose and directions for each medication
- Why you are taking each medication
- Which medications have been stopped
- Any new medications that have been prescribed
- Over-the-counter medications, vitamins and supplements you use
- Medication allergies or previous reactions
- Whether you are having difficulty taking medications as prescribed
- Whether medication cost is preventing you from taking a medication correctly
The goal is not simply to create a better list. It is to help make your medication regimen safer, more effective and easier to manage.
Medication Cost Is Part of Your Healthcare
There is another question that should be part of the medication conversation:
How much are your prescriptions costing you?
Prescription costs can add up quickly, particularly for people taking multiple medications every day.
Unfortunately, some patients respond to high medication costs by stretching a prescription longer, skipping doses, taking less than prescribed or stopping a medication altogether.
If cost is making it difficult to take your medication as prescribed, please tell your healthcare provider.
Do not simply stop taking a prescribed medication because you cannot afford it.
Depending on the medication and your individual health needs, there may be other options worth exploring. These can include a generic medication, another medication in the same class, a different pharmacy, manufacturer assistance or savings programs, or other cost-saving alternatives.
Not every option is appropriate for every patient, which is why these decisions should be discussed with your healthcare provider or pharmacist.
The Same Prescription Can Have Very Different Prices
One thing that surprises many patients is how much the price of the exact same medication can vary.
Your insurance copay is not necessarily the lowest available price.
Depending on the prescription, patients may want to compare their current cost with other legitimate options, including:
Cost Plus Drugs
Mark Cuban Cost Plus Drug Company offers many generic medications using a transparent cash-pricing model. For some prescriptions, the cash price may be lower than the price available through a traditional retail pharmacy or insurance plan.
Amazon Pharmacy
Amazon Pharmacy offers prescription medications through its online pharmacy. Pricing and available benefits vary, so patients should compare the final cost with their insurance and local pharmacy options.
GoodRx and Other Prescription Discount Programs
Prescription discount services such as GoodRx can help patients compare prices at participating pharmacies.
Keep in mind that discount cards are generally used instead of insurance for that particular purchase, so it is important to compare both prices. For Medicare beneficiaries, purchases made outside their Part D coverage generally do not count toward their plan’s out-of-pocket spending.
Your Local Pharmacy
Do not overlook your local independent pharmacy. Your pharmacist may be able to identify generic alternatives, available discount programs, manufacturer assistance or other ways to reduce your out-of-pocket costs.
The lowest-cost option will not always be the same for every medication or every patient.
Why This Matters Before Medicare Open Enrollment
Medicare Open Enrollment runs from October 15 through December 7 each year.
During this period, people with Medicare can review their current coverage and make certain changes for the upcoming year, including changes involving Medicare Advantage and Medicare prescription drug coverage.
Prescription coverage can vary from one plan to another. Formularies, preferred pharmacies, deductibles and out-of-pocket costs can also change.
That makes knowing your medications particularly important.
Before reviewing your Medicare options, consider creating an up-to-date list that includes:
- The exact name of each medication
- The dosage
- How frequently you take it
- Whether you take a generic or brand-name medication
- Where you currently fill the prescription
- Approximately how much you currently pay
Having accurate information can make it easier to evaluate how your medications may be covered under different options.
Lake Country Medical Group does not select Medicare plans for patients, but we can help you better understand your medications, which gives you better information to use when evaluating your coverage.
For official information about Medicare coverage and plan comparisons, visit Medicare.gov.
Don’t Forget Your Supplements and Over-the-Counter Medications
Medication reconciliation is not limited to prescription bottles.
Your healthcare team should also know about vitamins, supplements, herbal products and over-the-counter medications you take regularly.
Just because something is available without a prescription does not mean it cannot interact with a prescription medication or affect a medical condition.
Bring everything into the conversation.
A complete medication list gives your healthcare team a much clearer picture of your health.
How Lake Country Medical Group Can Help
For eligible patients enrolled in Lake Country Medical Group’s Chronic Care Management program, medication reconciliation is an important part of ongoing care.
Our team can help patients maintain an accurate medication list, identify potential medication-related concerns and recognize when cost may be creating a barrier to following a treatment plan.
That last part is important.
If medication cost is keeping you from taking your prescriptions as directed, tell us.
There may be an alternative medication, generic option, pharmacy resource or savings opportunity that your healthcare team can help you explore.
Your medications should work for your health, not against your budget.
Make October Your Medication Checkup
With Medicare Open Enrollment approaching, October is a natural time to take inventory.
Pull out your prescription bottles. Check your medication list. Include your vitamins and supplements. Look at what you are actually paying each month.
Then ask yourself:
Is my medication list accurate?
Do I understand why I am taking each medication?
Am I taking everything as prescribed?
Is cost making any of my medications difficult to afford?
If you are unsure about any of those answers, talk with your healthcare team.
At Lake Country Medical Group, we believe managing chronic conditions requires more than writing prescriptions. It means looking at the complete picture and helping our patients manage their medications safely, effectively and affordably.
To learn more about Chronic Care Management, medication reconciliation or the services available at Lake Country Medical Group, call 706-485-4004 or visit lakecountrymedicalgroup.com.
Want to Learn More About Connected Care?
At Lake Country Medical Group, our Connected Care Management program provides ongoing support to help eligible patients manage chronic conditions, stay on top of medications, and take a more proactive approach to their health.
Click here to learn more about our Connected Care Management program.
This article is for educational purposes and should not be considered individual medical, insurance or Medicare plan advice. Do not start, stop or change a medication without discussing it with your healthcare provider.
To schedule an appointment, call Lake Country Medical Group at 706-485-4004