8 Ways to Help Low-Income Patients Obtain Prescription Medications
The hard reality today is that an increasing number of patients are underinsured or uninsured. Patients who choose to take on the risks and go without insurance tend to face the decision to either skip necessary care or go into debt and pay for it. Unfortunately, however, those covered by insurance are often not much better off.
In 2016, half of all insurance policy-holders faced a deductible of at least $1,000. For people who buy the insurance through one of the Affordable Care Act’s exchanges, the figure was even higher, with almost 90% of patients who face a deductible of $2,600 for a family or $1,300 for an individual.
Even so-called insurance plans with generous reimbursements and low deductibles often leave a huge gap in patients and coverage, holding the bag for large medical bills. Many people have separate and often hard-to-understand out-of-network deductibles or lack out-of-network coverage altogether. If there are out-of-pocket medical expenses capped at $14,300 for a family of four, the expenses much cover an insurmountable number of family members.
The physicians and all care providers in the unenviable situation try to decide whether they will turn patients away for not being able to pay, accept less for services or find creative ways to help patients get the care they need while getting paid.
Although helping with fees can be tricky for patients that are covered by insurance since most insurance companies do not allow waiving deductibles or co-payments, there are things you can do to help patients, without or with insurance, who cannot afford to pay for their care.
In this blog, you will learn about how to save on prescription medications and ways to help low-income patients.
1. Have a money conversation
Discussing the options and costs may lead to cost savings for the patients without compromising the care quality. The problem is that the physicians do not have the training to discuss financial matters with patients. Therefore, they often feel it is inappropriate to bring up money during the patient’s visit.
However, the fact is that full disclosure of costs encourages the patients to plan and pay more promptly. If the patient is more informed about the approximate fees, they will likely pay.
One good way to start the money conversation is by asking a few questions on the patient intake form. For example, ask patients to tell you about any difficulty they are experiencing in paying past medical bills or concerns with the costs.
Your goal must be to bring the patient’s decision-making into the process. For example, something as simple as prescribing a 90-day medicine supply may help reduce out-of-pocket costs for medications. It would help if you also talked with patients about scheduling expensive tests later in the year when the annual deductibles are more likely to have been met. You can also suggest about how they can take insurance or free prescription discount card as an option.
2. Empathy towards patient concerns
With patients increasingly responsible for more of their health costs, finding affordable and appropriate care is much more important than it ever was. A good resource will help find hundreds of cost-effective options based on diagnosis and subspecialty. These range from tests and drugs to maintenance supplies and more.
3. Recommend patient assistance programs
Patient assistance programs, run by medical supply or pharmaceutical companies, government organizations, and nonprofit groups, help families and patients access or afford expensive supplies or medications. Make sure your patients have an up-to-date medication list, and for those who do not have regular access to phones or computers, suggest they work with a social worker, navigator, or another specialist.
Popular patient assistance programs include the RX discount cards, help programs, and pharmaceutical assistance programs.
4. Help or refer them to find assistance
If you and your patient do not agree on a fee or have already maxed out the number of low-cost clients you can afford, send them to a local community clinic or hospital. Many offer no-cost or low-cost care to patients with proven financial needs.
You can also help your patients afford the medical care costs by helping them find the assistance they want. Many organizations, both private and federal, assist pharmaceutical and medical intervention.
5. Reviewing insurance-specific drug approvals
Insurance companies do not have specific rules to cover certain medications outlined in the coverage library or drug formulary. For example, there’s a possibility that an extended-release Metoprolol is covered, but short-acting is not covered, and your patient may take either form. Reading the fine print may not be an exciting task, but it can help your patients save thousands on supplies and prescriptions. Try to prioritize the common insurance companies in your area and the most expensive medications you frequently prescribe.
6. See them Pro Bono
For the patients with extreme health conditions and financial problems to match. You may also consider offering them a care pro bono or at no charge. You cannot take care of your patients if your practice is in financial jeopardy, so only take on the number of pro bono patients you can comfortably afford.
7. Create a sliding fee scale
One way to offer a financial break to self-pay and low-income patients is to create a sliding fee schedule. It is the type of fee schedule that provides a discount based on a family’s income compared to the Federal Poverty Guidelines.
8. Offer a payment plan
Another option is to allow the patients to add the balance to a tab and pay portion of their fees that they can pay down over time or when the financial situation changes. Finally, you can set up a credit card on file and have the patients sign an agreement for a regular monthly charge to pay towards the debt.
Conclusion
If you want to practice patient-centered care, providers should make it a habit to help patients access the treatments. Not to mention, it is one of the much-needed services as more than 25 percent of insured Americans struggle to keep up with the routine healthcare bills. Almost 30 percent of US adults say they do not need medications as prescribed due to cost.
As providers, we need to learn the language of insurance companies, be upfront about cost, and use the resources as it can help the patients get the care they need without forcing them to skip necessary treatments or make tough financial decisions. However, prescription discount cards are the one best option to save money on prescription medications.
