Studies have shown that in general people are not comfortable communicating with their doctors. This is especially true of older generations where the word doctor was always synonymous with respect. The thought of questioning a doctor’s recommendations can be very intimidating for some people. After all, what if the doctor thinks I’m being difficult and doesn’t give me the same quality of treatment he does others?
As a Medicare insurance agent, our biggest challenge when working with clients is finding them the most suitable prescription plan, especially those with one or more brand name prescriptions. Typically, these are the folks that encounter the dreaded “donut hole”.
The question becomes is it always necessary for that person to take a brand name medication? As insurance agents we are not the ones to say if they should or shouldn’t take a medication. Also, we know that there are medications that do not have generic equivalents. Keeping that in mind, if a medication does not have a generic equivalent, that does not mean there are no other medications that have the same the same therapeutic attributes of that particular medication.
In fact, all Medicare Part D plans are required to cover two medications per category of sickness and “are required to make sure that people in their plan can get medically necessary drugs to treat their conditions.” For more information, click the following link. https://www.medicare.gov/Pubs/pdf/11109-Your-Guide-to-Medicare-Prescrip-Drug-Cov.pdf
Just because your doctor prescribed you the medication, does not mean you cannot ask the doctor if there is a cheaper alternative.
In fact, I would take it a step further. You can research a couple of alternatives and discuss them with your doctor. We often find that doctors will work with their patients to reduce high cost medication but not at the expense of jeopardizing their health. The problem is that many people are intimidated at the thought of questioning their doctor. I can’t say this loud enough, DON’T be intimidated by your doctor! Unless of course they are paying your bills. It is your right as a consumer to find out if there are more cost-effective medications or dare I say treatment options.
To be clear, we realize that at times a brand name medication may be more effective than either the generic equivalent or a drug in the same class that treats the same condition. My point is that if you need to choose between necessities like food and shelter OR taking your medication as prescribed, I suggest you talk to your doctor and come up with another plan. We routinely have people walk in our door facing several thousand dollars in drug costs, go back to their doctor, re-evaluate their medications and save substantial money.
If you are a person with expensive medications and are not sure what alternatives are covered by your plan, call customer service or ask your agent. They will either be able to provide the generic name or two like medications covered by your plan. Take this information to your next doctor visit to discuss other options.