percent opting out of healthcare graph If you’re a ScriptSave® WellRx member, you probably know only too well what it means to face high out-of-pocket costs for prescription medications. We hear this message from members every day and so it didn’t come as a huge surprise when we read details from a Bankrate.com survey.

One quarter of surveyed Americans report that they, or someone in their family, have skipped vital medical care because of the cost. The Bankrate Money Plus Survey also revealed that more than half of those who responded worry about not being able to afford health insurance.

Health Care Anxiety

The survey findings come at a time of rising healthcare costs and huge increases in some health insurance premiums, while increasing insurance deductibles further weigh on the issue. In the survey, 56% say they’re either very or somewhat worried that they might not be able to afford health coverage in the future.

percent concerned about healthcare coverage graph

High-deductible Dilemma – An Expensive Healthcare Punt

High-deductible plans and HSAs (Health Savings Accounts) have been central in the healthcare debate. Such plans hype lower monthly premiums, as compared to traditional insurance. For many, this ends up being little more than an expensive punt (what gets ‘saved’ in premium costs comes back to bite many patients in the form of much higher out-of-pocket expenses when they submit a claim to their insurance provider).

In 2016 the average annual premium for employer-sponsored health insurance was $6,800 for single coverage in a preferred provider organization (PPO), according to data from the Kaiser Family Foundation (KFF).

By comparison, the average annual premium for a high-deductible health plan available through an employer was somewhat more affordable. KFF found that to be $5,762. The trade-off for the lower premium is that the consumer is responsible for saving the necessary amount of money needed to meet a higher deductible in the event of illness or requiring medical attention. In theory, under a high-deductible plan, employees can use a tax-advantaged HSA to cover qualified medical costs so these premium savings can be deferred, tax free, in order to meet future medical expenses. However, for many, this simply does not happen.

Saving Where You Can

No matter how the debate on healthcare reform ends up playing out, here are some things a savvy patient might wish to think about now to make the most of their existing insurance benefits:

  • Get an annual checkup: Finding out if you have early underlying health issues earlier in the year and treating them, brings you closer to meeting your deductible before year-end.
  • Consider low-cost health care alternatives: See if your insurance plan grants access to telehealth services. These online virtual doctor visits can be an inexpensive (and faster!) alternative to many minor medical conditions.
  • Know your network: While your Primary Care Provider may be in-network, many specialty physicians and services may not be. You’ll be paying more for care from out-of-network services, and what you pay may not go toward your annual deductible. 
  • Get a free ScriptSave WellRx prescription savings card (or mobile app): For those facing high out-of-pocket costs for prescription drugs, be it due to a gap in insurance or high insurance copays/deductibles, a free download of the ScriptSave WellRx prescription savings card might help. As a patient, the card (or mobile app) won’t cost a penny to use. If it helps, great—enjoy the benefit of a lower-cost medication. If not, then it didn’t cost anything to try. That said, this savings program did yield an average savings rate is 45% (with savings up to 80%*) in 2016, and the ScriptSave WellRx program is contracted with over 62,000 pharmacies, nationwide. You might be surprised to find out you’re eligible for low-cost prescriptions with your ScriptSave WellRx card.

References:

http://www.cnbc.com/2017/06/07/heres-why-a-quarter-of-american-families-are-skipping-their-doctor-visits.html

http://www.bankrate.com/banking/savings/money-pulse-0617/ 


For the best Rx price on medications,
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Impacts to Out-of-Pocket Prescription Drug Costs

TUCSON, AZ (February 16, 2017) – A December 2016 analysis by the Kaiser Family Foundation illustrates how prescription medications will be a large portion of overall healthcare spending, and how branded drug prices have nearly doubled. The analysis also explains that 1-in-4 people have difficulty affording their medicines, and that most Americans favor actions to keep drug prices down, (Kaiser Family Foundation, 2016).

Unfortunately, a repeal and replacement of the Affordable Care Act (ACA-Obamacare) could end up increasing drug costs to insured consumers and leaving millions of Americans uninsured. A report written by the Congressional Budget Office states, “repealing major provisions of the Affordable Care Act, while leaving other parts in place, would cost 18 million people their insurance in the first year and an estimated 32 million people in 2026,” (Congressional Budget Office, 2017). The study also projects that insurance premiums would increase by 25 percent in the first year, then double by 2026.

Regardless of the changes made to the ACA, the end-result will have detrimental impacts on the American healthcare coverage. Even a partial repeal could include heavy changes that will increase costs to consumers.  Insurance plans may no longer be required to cover essential health benefits (EHB) in accordance with benchmark plans. Examples of the potential impacts include:

  • Removal of no-cost preventative coverage
  • Restrictions on maternity and family planning coverage
  • Exclusions of prescription drugs for many diseases and conditions
  • Elimination of prescription drug coverage altogether

The message is clear, even for those retaining their insurance – Americans will be shouldering more out-of-pocket costs for prescription drugs.

“Any reduction in benefits to emerge from a replacement of the law, especially to the essential minimum benefit set, would likely drive patients without adequate drug coverage to seek solutions to combat high priced prescription drugs,” stated Rory Rickert, Principal with QuarterLine Consulting, a national healthcare consulting and services firm.  “I expect that changes to the Affordable Care Act would, if anything, result in increased demand for pharmacy discount programs like those offered by ScriptSave,” added Rickert.

To help populations gain some relief from the upcoming change in their healthcare, ScriptSave® WellRx provides an alternative to paying full price for prescription medications. WellRx enables individuals to compare prices at local pharmacies, look up drug information, and setup reminders. Through a partnership with SinfoníaRx, members can even consult with a pharmacist to ask detailed questions about the medications they are taking.

Not only does WellRx give discounts on prescriptions not covered by insurance, it may even provide discounted prices lower than insurance copays. The program is available as a stand-alone for consumers (wellrx.com), white-labeled option for organizations, or an integrated solution for health care organizations (WellRx Connect).

“The future of healthcare is uncertain at this time, but no matter the outcome, no one should ever overpay for prescription medications. ScriptSave can help healthcare consumers with high deductible health plans, limited insurance, or no health insurance at all,” said Marcus Sredzinski, COO and Executive Vice President, ScriptSave. “Our products help consumers save money on prescriptions, understand their medications and, most importantly, remain adherent.  We can help organizations and individuals impacted by the repeal and replacement of ACA, or any changes to their insurance status,” added Sredzinski.

This may be especially poignant in light of recent data published by PatientsLikeMe. From a poll of over 2,000 patients, their survey showed:

  • 65.5% stated that lower costs for prescription medications was a top priority
  • A further 30.8% rated lower Rx costs as being important
  • Fewer than 4% had little-or-no concern about prescription prices

Furthermore, it’s not just patients with existing health conditions that rank lower prescription costs as a priority – the general public seems to agree. Data from a December 2016 Kaiser Health Tracking Poll found that lowering the cost of prescription drugs was listed as being important or a priority for 89% of the general population.

When opinions like these are voiced, ScriptSave is ready to help by doing what they do best, lower the out-of-pocket costs of prescription medications for consumers.

ScriptSave’s long-standing mission has been to close the gaps in prescription coverage, and has a 20-year history of working with health plans and pharmacies to provide consumers with discounts on prescribed medications. ScriptSave’s WellRx solutions are not only designed to assist consumers directly but can be utilized by employers, employer groups, health plans, PBMs, and other organizations to assist their populations with prescription adherence, savings, and information. The WellRx savings network includes about 62,000 independent and chain pharmacies. In 2016 alone, ScriptSave earned members more than $1.3 Billion in savings.

References:

The Henry J. Kaiser Family Foundation. Analysis of National health expenditure Historical and Projected data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group (Assessed on December 16, 2016). http://kff.org/slideshow/what-are-the-recent-and-forecasted-trends-in-prescription-drug-spending/

Congressional Budget Office (January 2017). How Repealing Portions of the Affordable Care Act Would Affect Health Insurance Coverage and Premiums. https://www.cbo.gov/sites/default/files/115th-congress-2017-2018/reports/52371-coverageandpremiums.pdf

PatientsLikeMe (February 2017). Largest Patient Poll on ACA Shows Patients Value Health Care Law More Than the General Population, Are Less Inclined to Want a Repeal. http://news.patientslikeme.com/press-release/largest-patient-poll-aca-shows-patients-value-health-care-law-more-general-population-

The Henry J. Kaiser Family Foundation (January 6, 2017). Kaiser Health Tracking Poll: Health Care Priorities for 2017. http://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-health-care-priorities-for-2017/

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About ScriptSave:

For more than two decades, ScriptSave has been closing the gaps in healthcare and prescription coverage with innovative savings programs for the uninsured, under-insured, and insured. Headquartered in Tucson, ScriptSave solutions, analytics, and unique expertise save consumers money and increase medication adherence, while attracting and retaining loyal, profitable customers, members, and patients for our clients. ScriptSave is a member of the MedImpact, Inc. family of companies. For more information, go to www.scriptsave.com. Follow us: @SSWellRx (Twitter), ScriptSave WellRx (Facebook).

About QuarterLine:

QuarterLine is a health-focused services company specializing in providing Information Technology, Clinical, and Professional services to federal and private sector customers. QuarterLine supports a diverse client base in all areas of health, including navigating the complex regulatory and business environments, emerging health programs, and technology. QuarterLine’s mission is to provide the right level of support at the right time to our customers to ensure that the outcome of the initiative or the resulting technology delivers the needed results to improve healthcare delivery and increase efficiency. QuarterLine is headquartered in Herndon, Virginia. www.quarterline.com

About SinfoníaRx:

SinfoníaRx, a wholly owned subsidiary or Sinfonía Healthcare Corp, is an innovative health care company whose mission is to provide the highest quality healthcare solutions for health plans, patients, and caregivers. We improve the health and wellness of patients with complex and chronic illnesses through the use of innovative healthcare technology and the most experienced medication therapy management providers in the nation.  www.sinfoniarx.com

 

ScriptSave Contact:

Shawn Ohri, Vice President of Business Development
sohri@scriptsave.com

QuarterLine Contact:

Rory L. Rickert, Principal
480-451-0148
rrickert@quarterline.com

Sinfonía Contact:

Kevin Boesen, 520-499-3376
KPBoesen@sinfoniarx.com

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