If you cannot afford a prescription, do not wait until the last dose if you can avoid it. Call the doctor or clinic that prescribed it and the pharmacy. There may be a lower-cost medicine, discount, patient program, or short-term solution.
1. Tell the prescriber the price is the problem
Doctors may not know what you are paying. Say: “I cannot afford this prescription. Is there a lower-cost medicine, generic, or other treatment that may work for me?”
2. Ask the pharmacist about the cash price
The cash price can be different from the insurance price. Ask the pharmacist to explain the options. If you use a discount program, ask whether it counts toward your insurance deductible.
3. Ask about a generic or lower-cost alternative
Do not change medicine on your own. Ask the prescriber whether another drug or dose is safe for your condition.
4. Check patient assistance programs
Some drug makers and nonprofit programs help people who meet income or insurance rules. The clinic, pharmacist, or social worker may know where to apply.
5. Ask community clinics and health centers
Community health centers may have lower-cost pharmacies, discount arrangements, or staff who help patients find affordable medicine.
6. If insurance denied the prescription
Ask why. The insurer may require a different drug first, prior approval, or more information from the doctor. Call the prescriber and ask them to work on the denial.
7. If you are almost out
Tell the clinic how many doses remain. Ask whether a short refill, sample, bridge supply, or urgent appointment is appropriate. The answer depends on the medicine.
8. Never split, skip, or stop a medicine without advice
Some medicines can be dangerous to stop suddenly. Ask a health professional before changing how you take a prescription.
9. Compare pharmacies carefully
Prices can differ. If you move the prescription, make sure the new pharmacy can fill it and that the prescriber does not need to send a new order.
10. Watch for fake online pharmacies
Be careful with websites that sell prescription drugs without a prescription, hide their location, or promise very low prices for controlled or high-risk medicines.
A simple call script
“This medicine costs $___ and I cannot afford it. I have ___ doses left. Is there a safe lower-cost option, patient-assistance program, generic, or short-term supply while we work this out?”
What to bring to the pharmacy or clinic
- Medicine name and dose
- Insurance card
- Prescription bottle
- List of other medicines
- Income information if a program asks for it
Common mistakes
Do not buy prescription medicine from an unverified website. Do not use someone else’s medicine. Do not cut tablets unless a pharmacist or prescriber says it is safe. Do not wait until after the last dose if you already know cost is a problem.
If the medicine is brand-name
Ask whether a generic exists. If not, ask whether the drug maker has a patient-assistance program or copay help. Some programs are for uninsured people, while others help certain insured patients. Rules differ.
If you take several medicines
Ask the pharmacist to review the list for lower-cost options. Sometimes one expensive medicine has an alternative while the others do not. Work through the list one drug at a time.
Keep a medicine-cost record
Write the normal price, discount price, insurance price, and pharmacy. This makes it easier to compare next month and to show a clinic why cost is a problem.
When the problem is transportation
If you cannot get to the pharmacy, ask about delivery, mail order, a closer pharmacy, or transportation help. A low price is not useful if you cannot safely get the medicine.
If the pharmacy says insurance will not pay
Ask whether the problem is a prior authorization, refill-too-soon rule, formulary issue, quantity limit, or expired prescription. Each problem has a different fix. Write down the exact reason and call the prescriber.
If you are between insurance plans
Tell the clinic how long the gap may last. Ask about low-cost pharmacies, community health centers, and temporary assistance. If new coverage starts soon, ask whether a short supply is medically appropriate.
Do not hide cost from your doctor
Cost is part of treatment. A medicine that you cannot buy does not help you. Tell the prescriber before the next visit if price is making you skip doses.
Keep emergency numbers handy
Know what symptoms mean you should seek urgent care if you miss a medicine. Ask the doctor or pharmacist this question before you run out.
If you use insulin or another temperature-sensitive medicine
Ask the pharmacist how to store it safely and what to do during a power outage or housing emergency. Do not use medicine that was stored outside safe conditions without professional advice.
If the medicine has a high deductible
Ask the insurer whether the cost will change after the deductible, and ask the prescriber about alternatives that may have a lower covered price. A discount card can help at the counter, but using it may not count toward the deductible.
Plan the next refill early
Once you find a lower-cost path, write the refill date on your calendar. Start the assistance renewal or prior authorization before the current supply runs out.