6 Questions to Ask Your Healthcare Provider About Out-of-Pocket Medication Costs

Even in the privacy of a doctor’s office, many patients hesitate to discuss one subject — money.

While nearly one in four Americans over the age of 50 feels stressed about their medical bills, only half of those have spoken to their healthcare provider about it, according to a University of Michigan poll. But it pays to ask about the cost of your treatment. The same poll found that two-thirds of patients who talked to their healthcare provider about drug costs received a recommendation for a lower-cost alternative.

Speaking with your healthcare provider about treatment options and out-of-pocket costs should be one of the first things you do after being diagnosed with a chronic illness. But sometimes it can be hard to know how to start the conversation, or what questions to ask. As the largest independent charitable organization dedicated to helping people pay out-of-pocket costs for their prescribed treatments, the Patient Access Network (PAN) Foundation helps patients manage the financial burden of care every day. Dan Klein, President and CEO of the PAN Foundation, suggests asking your healthcare provider the following questions if you are concerned about the cost of your medication.

1. Can you or someone in your office help me find out how much this medication will cost out-of-pocket?

Although drug prices fluctuate, and patients pay different amounts depending on their health insurance, healthcare providers or their staff can usually provide an estimated cost for a treatment or can call your pharmacy and find out. This simple question is an easy way to start the cost-of-care conversation and let your healthcare provider know that you want to explore ways to minimize your costs.

2. Does this medication have a generic equivalent that I can use?

Many brand-name drugs, especially those that have been on the market for a long time, have generic equivalents that are significantly cheaper. These generic copies contain identical active ingredients and are rigorously tested by the FDA to ensure they are as safe and effective as the brand-name versions.

3. Could a change in dosage or frequency help reduce my costs, but still be effective?

Out-of-pocket costs should not prevent you from accessing and adhering to your treatment. But controlled changes to your dosage or frequency may help you lower your costs without compromising effectiveness. It’s crucial that this is only done under medical advice, as making cost-cutting decisions without your healthcare provider’s input can be harmful.

4. Is there a less expensive way to receive my treatment?

Depending on your condition, there may be multiple ways to receive treatment, some more expensive than others. For example, oral anti-cancer agents have become an increasingly common part of cancer treatment plans but are sometimes more expensive than traditional intravenous (I.V.) administration. Be sure to ask your healthcare provider if there is a cheaper treatment option for you that meets your healthcare needs.

5. Do you have drug coupon discount cards for my medication, or free samples?

Drug companies often give healthcare providers discount coupons or free samples to dispense to patients. It can be easy for healthcare providers to forget about these, so don’t be afraid to ask! Drug manufacturer discount coupons can only be used by those with commercial insurance, not by people with Medicare or Medicaid.

6. Can you or someone in your office help me find financial assistance to cover my costs? Is there a charitable foundation that I can apply to?

Charitable foundations, like PAN, can help patients pay their out-of-pocket costs for prescription medications. Your healthcare provider’s office should be familiar with these programs and can point you in the right direction. You can learn more about patient assistance charities and connect with resources to help you manage your chronic illness at panfoundation.org. You can also download the FundFinder app from that website, which will notify you when assistance becomes available from any of the major charitable patient assistance foundations.

Author Profile

The Editorial Team at Lake Oconee Health is made up of skilled health and wellness writers and experts, led by Daniel Casciato who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We aim to provide our readers with valuable insights and guidance to help them lead healthier and happier lives.