Save on Prescriptions-Use Direct Primary Care!

Often as I speak with insurance clients, I suggest to them to enroll with a Direct Primary Care physician and pair that with a high deductible, catastrophic health insurance plan, but sometimes I get pushback from clients who are unwilling to pay for both, especially since even catastrophic coverage is expensive these days.

But one thing consumers don’t realize is that in many cases, prescription savings alone can easily pay for the cost of the DPC membership.  Let me give you an example.  A few weeks ago, I was researching health plans for a client who takes Cymbalta. Well it turns out that most individual insurance plans in Colorado won’t even cover Cymbalta anymore, except for the generic alternative.  But in this person’s case, she was allergic to an ingredient in the generic, and could only take the brand name.  Well Cymbalta runs about $230 retail, so that would have been an additional monthly cost for this consumer on top of her health insurance plan.  But what if she used  Direct Primary Care doc for her routine care and prescriptions?  Her monthly fee for unlimited, 24×7 primary care would have been approximately $65, AND, she would have access to monthly Cymbalta for about $15!  I’m blown away by the savings available on Cymbata, Effexor, Omeprazole, Imitrex and others.  It just makes sense to look into DPC as a way to obtain affordable Rx pricing for routine medications.

Below is a picture of some sample Rx pricing that I obtained from a DPC in PA called Core Family Practice.  I hope Dr. Haug doesn’t mind me sharing this with you!  Just look at Rx savings examples!  These savings alone are a no-brainer.  Everyone, especially those who need routine medications should consider Direct Primary Care.  It’s not a replacement for major medical coverage, but it can pay for itself and give you a quality of service that you never thought possible from your primary care doctor.

Sample Rx Pricing from Direct Primary Care




Don’t Pay More Than You Need To for Medications

Many people are unaware that the cost of their routine medications are sometimes actually less than the cost of the copayment on thier health insurance plan.  When filling prescriptions, it would behoove you to ask your pharmacist the cost of the Rx both with and without insurance.  Sometimes, it’s a better deal to use an app such as The Healthiest You, to compare drug prices in advance, to make sure that your insurance is getting you the best deal, before you buy! You may save as much as ten times the cost of an Rx, just by paying cash. This is especially true if your Rx is generic.  Bear in mind, if you choose to purchase your Rx outside of your insurance plan, the cost, of course will not apply to either your plan’s deductible or maximum out-of-pocket, but if you don’t anticipate meeting those thresholds, you may be better off just cash paying for your Rx.

Another way to save on routine medications is to use a Direct Primary Care physician.  DPCs often have wholesale pharmacies in-house and do not mark up the cost of routine medications.  You may even save enough on medications to cover the monthly cost of a DPC!

To save even more, check with your doc to find out if your pills can be split.  If so, have your doc prescribe a double dose of the medication, and use a pill splitter to get twice as much medication for your money.  Many generic prescriptions cost the same whether the dose is 10 mg or 20 mg, as an example.  Pill splitters can be obtained at a local pharmacy, and are a great way to help you make the most of your Rx dollars.

If you are taking an expensive brand name drug, and are having trouble affording the cost, check with the drug manufacturer of the Rx to find out if they have any patient assistance programs.  Sometimes, the manufacturer offers special deals for those who have low incomes or are without insurance.


Four Apps that Every Healthcare Consumer Should Know About

  1. Healthiest You
    Healthiest You is an application that every healthcare consumer should have, especially if you have an insurance plan with a high deductible. Here are the highlights:
    a.) Offers $0 Copay, 24 X 7 access, to board certified Teladoc networked healthcare providers for non-emergent medical care such as treatment for sore throat, upper respiratory disease, pink eye, urinary tract infections, and so much more.  This service claims to be able to treat 70% of issues that you would otherwise have to visit a PCP or urgent care center for, saving you time and hundreds of dollars.
    b.) Provides a “radar” map in which you can find doctors, veterinarians, pharmacies and clinics near you.
    c.)  Provides a tool for comparing Rx costs among pharmacies, so cash payers can always find the best price for their prescriptions.  In many cases, competing pharmacies may even be able to beat your health insurance co-payment.
    d.) Syncs with your current health insurance plan to help you track deductibles and out-of-pocket costs, and find healthcare providers that network with your plan.
    e.)  Provides a tool to help you determine the approximate out-of-pocket costs for high cost procedures such as imaging and surgery.
    f.)  Provides a place to store you and your family’s medical history information, so it is easy to find at the touch of a button.
  2. 2nd.MD
    2nd.MD provides direct access to leading medical specialists for personalized second opinions via video or phone.
  3. CareZone
    CareZone helps subscribers manage their health or the health of a family member with tools for managing medications, contacts, files, journals, calendars, to-do’s and more.
  4. Pillsy
    Pillsy is smart container technology and a mobile app that makes it easier to manage medications, vitamins, supplements and other pills.