Paying for prescriptions as a student

The price of a prescription depends on your plan, your pharmacy and the version of the medicine, and this page explains how those pieces fit together. It also lists questions you can ask a pharmacist to bring the cost down.

How plans set drug costs

Each health plan keeps a formulary, a list of the medicines it covers sorted into tiers. Lower tiers, often made up of generics, usually carry the smallest copay, while higher tiers cost more.

Some medicines need prior authorization, which means your prescriber has to send the plan information before it will pay. Others fall under step therapy, where the plan asks that a different covered medicine be tried first. Your plan's member portal or member services line can tell you where a drug sits on the formulary.

Generics and other versions

A generic medicine has the same active ingredient as the brand-name version and is approved by the FDA. Generics usually cost less, and many prescriptions can be filled with one.

Ask your prescriber or pharmacist whether a generic or another covered medicine is an option for you. Only your prescriber can change what is prescribed, so raise cost questions at the appointment.

Bring to the pharmacy

• Your insurance card
• The name and dose of the medicine
• Your prescriber's contact details
• A list of other medicines you take

Choosing a pharmacy

Plans have pharmacy networks, and a pharmacy outside the network can charge you much more or the full price. Some plans also offer mail-order service for medicines you take regularly, often for a longer supply.

If your school has an on-campus pharmacy, ask which plans it accepts. When you move between home and school, ask the pharmacist before transferring a prescription, since some medicines have stricter transfer rules.

Questions to ask at the counter

Ask what the price is with your insurance and what the cash price is, since the two can differ. Pharmacy discount cards sometimes lower the cash price, but a purchase made with one usually does not count toward your plan's deductible.

If the cost is still too high, ask whether the manufacturer runs a patient assistance program or a copay card. Rules for these programs vary, and copay cards generally cannot be used with government coverage such as Medicaid.