As part of our ongoing efforts to highlight wellness initiatives that are working well and exploring alternatives to help mitigate the rising costs of health insurance—including prescription medications—we’re excited to share real-life stories from our community. These experiences may offer valuable insights and help you find solutions that work for you.
In today’s spotlight, one of our library colleagues shares her experience with our prescription benefits as well as an alternative option that provided deep discounts. Please read on to learn about her experience and find a comprehensive listing of similar alternative programs that can save you money at the pharmacy.
Shared Experience – How the New Drug Benefits Led Me to an Alternative
“In 2010, I was diagnosed with multiple sclerosis (MS), and I rely on expensive specialty medications to manage the disease. When the College switched to Prime, my copay for the medication increased from $10 (the previous price for generic medication) to $100 (the new price for specialty medication). After reviewing my EOB statements, I discovered that the College was being charged over $6,000 monthly for my medication. This led me to seek a more affordable alternative, which I found through Mark Cuban’s Cost Plus Drugs.
A coworker introduced me to this option, and I decided to give it a try. With Cost Plus Drugs, my total cost for three months of medication is now $100, compared to the previous $100 for just one month through Prime. Additionally, with Prime, I had to make monthly calls or text conversations to renew my prescription. Now, everything is managed online, and I only need to refill four times a year.
Since using Cost Plus Drugs, I’ve spent less time dealing with pharmacies during the workday, which has improved my productivity and overall well-being. My advice to colleagues considering these benefits: check out Cost Plus Drugs—it could save both you and the College a significant amount of money.”
Prescription Funding or Discount Programs Information
We would like to thank this colleague for her willingness and candor in sharing her experience with us. While the College does not endorse any of the prescription funding or discount programs, there are a significant number of them that have emerged over the last few decades, and we would like to provide you with a more comprehensive listing should you be interested in exploring your options. Here are several programs and services that provide discounts or funding for prescription medications:
Discount Card & Cash-Pay Programs
- GoodRx – A free service that provides prescription discounts through coupons and price comparisons at major pharmacies. Offers additional savings with the GoodRx Gold subscription. No insurance required.
- SingleCare – Offers free discount cards and coupons for prescriptions at major pharmacies.
- RxSaver by RetailMeNot – Provides discounts on medications, similar to GoodRx.
- Optum Perks – A prescription discount program by Optum, offering savings at various pharmacies.
- ScriptSave WellRx – A free discount card and app for reducing prescription costs.
- Blink Health – Allows users to prepay for medications online and pick them up at participating pharmacies.
- US Pharmacy Card – A free discount card providing savings at most major pharmacies.
Low-Cost Online Pharmacies
- Cost Plus Drugs (Mark Cuban) – A transparent pricing model with low-cost prescriptions.
- DiRx – An online pharmacy offering direct-to-consumer prescription drugs at low prices.
- Alto Pharmacy – A digital pharmacy that delivers medications with cost-saving options.
- Amazon Pharmacy – Offers competitive cash prices and discounts for Prime members.
Patient Assistance Programs (PAPs)
- NeedyMeds – Provides information on drug assistance programs and free/low-cost clinics.
- RxAssist – A database of pharmaceutical company PAPs that offer free or low-cost medications.
- Partnership for Prescription Assistance (PPA) – Helps patients find medication assistance programs.
- Pharmaceutical Company PAPs – Many drug manufacturers offer assistance programs for specific medications (e.g., Pfizer RxPathways, Lilly Cares, GSK For You).
State & Nonprofit Assistance Programs
- Michigan’s Prescription Drug Discount Card (MiRx) – The MiRx Card is a prescription drug discount program for Michigan residents who do not have any prescription drug coverage.
- HealthWell Foundation – Provides copay assistance for people with chronic conditions.
- PAN Foundation – Offers financial assistance for underinsured patients.
- Patient Advocate Foundation (PAF) Co-Pay Relief – Helps cover medication costs for those with financial hardships.
- Good Days – Provides funding to eligible patients for high-cost medications.
Conclusion
We hope that this shared experience has shed light on the power of exploring alternatives when it comes to managing healthcare costs, especially for prescription medications. As we all face rising expenses, it’s encouraging to know that there are solutions available that can help alleviate financial strain without sacrificing quality of care. By sharing these experiences, we aim to create a supportive environment where colleagues can learn from one another and take advantage of available resources.
We encourage everyone to explore the options that may best meet their needs and to continue seeking cost-effective solutions. Remember, you’re not alone in this journey—there are plenty of resources to help ease the financial burden. Please take some time to review the comprehensive list of alternative programs provided, and don’t hesitate to reach out for more information.
A polite reminder to our readers: If you wish to comment on or share your thoughts about the experience shared, please do so respectfully and thoughtfully. We appreciate a supportive and constructive dialogue that fosters a positive atmosphere for all.
Thank you again to our colleague for her valuable insight, and we look forward to sharing more success stories as part of this ongoing wellness initiative.
I experienced a similar situation with a particular GENERIC medication that used to cost me $20 for a 90-day supply when we were with Ascend. Once we switched to Magellan (now Prime), it was going to cost me $100 per month. This is ridiculous! I worked with my doctor’s office and, if they switched me to name-brand, I could get my medication for $15 a month, through a copay card that the manufacturer offers. Though it is still more than I was paying before, it is considerably less than I would have had to pay.
I am not happy using Prime for my specialty medications. Most importantly, in my situation, it is best for all medications to be handled through the same pharmacy so that they can watch for drug interactions. Because of two of the specialty medications that I take, if something is prescribed for another situation, it is imperative that that there are no drug interactions. It’s hard for that to be monitored if my prescriptions are with multiple pharmacies. Prime is a hassle with refills. They make automated calls and the recording says it’s time to refill a prescription yet, when I get someone on the phone, they aren’t allowed to tell me which one it is. I get a different person every time I talk to them and they are in Florida. When we were with Ascend, I used Optimed here in town for everything. I worked with one person whom I built a good relationship with. She knew me and knew my history. When it was time for refills, she called me at the appropriate times and we walked through the list together.
While I want nothing to do with anything related to Mark Cuban, I was not even aware that we could use other places for specialty medications. My understanding is that we have to go through Prime. Since this is apparently an option, it would be helpful to know what other places we are allowed to contact for discounted medication prices.
I am very grateful for our health coverage, but I hope that when the next round of changes is planned, returning to Ascend/Optimed is considered.
I’m sorry to hear about the challenges you’ve faced since the transition to Prime as our Pharmacy Benefit Manager. I appreciate you taking the time to share your concerns.
Regarding your comment about alternative options for specialty medications, are you specifically looking for a list of additional discount programs beyond those mentioned in the spotlight article? Since the College does not endorse any particular program, we provided a comprehensive list of available options to help you explore what may work best for you. For your convenience, I’ve hyperlinked the article here in case you’d like to review the information again.
Please let me know if there’s anything else I can do to assist you.
Best regards,
Miasha
Although I’m glad that this person was able to find a viable solution to this one specific issue by going to a third party, I would argue that they shouldn’t *have* to. Furthermore, increased prescription costs are only one problem that has been introduced by the college’s change in prescription coverage. My family has had medications that they have had for *years* suddenly denied entirely or the prescription insurance company has demanded that their physician prescribed medication be changed to a completely different type…a type that our physician has already determined does not work and is not suitable. Every time we order a prescription refill, it’s a round of phone calls because *every time* the insurance company tries to deny it and we have to spend hours on the phone going back and forth with them and the pharmacy to clear up a “mistake”. Every. Time. It’s frustrating. It’s maddening. I’m not the only one that is experiencing this.
Thank you for taking the time to share your experience. We understand how frustrating and challenging these issues have been, and we sincerely appreciate you bringing them to our attention.
We recognize that increased prescription costs and access issues have created difficulties for many of us. While we are glad that some employees have found viable solutions through third-party options, we agree that this should not be the only path forward. As we continue to assess the impact of the prescription coverage changes, we are committed to identifying sustainable solutions that meet the needs of our employees while also ensuring the College’s financial sustainability.
Your feedback is invaluable as we work toward finding solutions that balance employee well-being with the College’s broader strategic goals. We encourage you to continue sharing your experiences, as your insights play a key role in shaping future decisions. If there are specific cases where we may be able to provide guidance or assistance, please don’t hesitate to reach out.
Be well,
Miasha
So my takeaway is that my colleague is paying for a benefit she’s not getting.
I agree with others that Prime is not useful. The constant Prior Authorization requests — for medications I’ve been taking for years — is just busywork that isn’t saving anyone any money. It’s just delaying care.
It’s ridiculous for Prime to deny prescriptions because somebody in Florida thinks they know better than a doctor. Why are we paying for a benefit we can’t use?
Thank you for sharing your experience with Prime and the challenges you’ve encountered with prior authorization requests. I understand how frustrating it can be to face delays in accessing necessary medications, especially when they have been prescribed consistently over time.
As you pointed out, the College currently covers 86% of the cost of benefits while employees contribute 14%. Given this structure, it’s important that all parties are able to fully utilize the benefits available to them. When access to prescribed medications is hindered, it raises valid concerns about whether we are receiving the value we expect from our healthcare coverage.
Concerns will be shared with our broker to explore potential solutions during the next renewal cycle. We truly appreciate your thoughtful feedback as we work toward a benefits plan that remains both accessible and financially sustainable for everyone.
Be well,
Miasha