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Tips for saving on prescriptions and procedures
If you have problems with health insurance or can't afford a procedure or prescription, it can be a challenge to figure out where to turn, but a patient advocate is here with some possible solutions.
Prescription prices can be extravagant and often unaffordable.
David Wilcox, DNP, who has been treating patients for almost 30 years, is speaking out about alternative ways to afford healthcare.
"Insurance companies and pharmaceutical entities have been making major profits at our expense, and sometimes even at people's lives. We basically have some people rationing insulin! I read an article about a 22-year-old young lady who died because she was rationing insulin to try to get from paycheck to paycheck. That should not happen and there are many avenues now for the average American to be able to get those high price prescription drug prices at a lower cost," explains Dr. Wilcox.
RELATED: 27-year-old who couldn't afford $1,200 insulin copay dies after trying cheaper version
One way is through a new online pharmacy.
Dallas Mavericks owner Mark Cuban opened an online pharmacy in January that offers prescription drugs at-cost.
Cuban, who also appears on Shark Tank, says Cost Plus Drugs will buy medications directly from their manufacturers and then sell them at lower prices.
"You can get your prescriptions for what you would normally negotiate from the manufacturers, plus 15% to keep the business viable and another 5% to get it shipped," says Dr. Wilcox.
LEARN MORE: Mark Cuban-backed online pharmacy promises to slash prescription drug prices
Cost Plus Drugs does not accept insurance and asks customers to pay out of pocket. While some savings can be in the thousands of dollars, most of them fall in the double digits.
A big box store is also making prescription drugs more affordable.
"Walmart is doing a really cool thing, too. So, Walmart is getting insulin for about $70 a vial and they're dealing with the manufacturer of it over in Norway. They've cut out all the middlemen, and they're starting to offer that, as well as generic prescriptions for around $4," states Dr. Wilcox.
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Walmart to begin offering lower-priced insulin
Walmart will begin offering lower cost insulin at its pharmacies. Tracey D. Brown, CEO of the American Diabetes Association, discusses this.
"Not a lot of people know that, but it's driving a lot of business to Walmart because people are picking up their prescriptions there, and their insulin there, and they're getting it in a very cost-effective way."
Dr. Wilcox also suggests the Good RX app to compare pharmaceutical prices.
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He encourages patients who plan to undergo a procedure to shop around first.
"If I go to get a total knee (replacement) done in my area, in a hospital it's going to cost me about $12,000. If I go to an ambulatory surgical center, which you have to be pretty much healthy to do that, it's going to cost me $8,000, but the hospitals won't tell me this," says Dr. Wilcox. "There was an executive order that went out on January 1, 2021, that said they had to give you price transparency for a boatload of procedures on their website. Well, a lot of hospitals, 95% of hospitals aren't complying with that because the fine is only $300 a day, so it's basically $110,000 a year and they'll eat that cost to keep that information from the American public."
It can be tough to find the information, but Dr. Wilcox makes all kinds of suggestions in his new book "How to Avoid Being a Victim of the American Healthcare System."
He suggests an app to find the prices of procedures.
"Healthcare Bluebook is another app that you can use, so there may be some subscription fees for that one, but it will help you determine in your area what a total knee (replacement) costs or what any other procedure or surgery will cost you, so that's one way you can get a ballpark figure of what it should cost," states Dr. Wilcox.
Dr. Wilcox also suggests you take your research to another level and don't settle for less.
"Look at the hospital's star ratings at Centers for Medicare & Medicaid Services and look at your doctor's star ratings. This is feedback from the actual patients themselves and what they say about the hospital, what their experience was and what their experience was with a doctor," explains Dr. Wilcox. "You don't want to go anywhere that's less than four stars."