One of those routine healthcare expenses that we’d all like help with is prescription costs—particularly if you have medications you take every day. Unfortunately, if you are shopping for a health share, you probably found that few companies are willing to pay for your meds.
Since health shares are really meant for big expenses, they do not focus on smaller or routine costs. However, you should expect your health share to help make your medication costs more manageable. Here are three ways a health share will help you pay for prescriptions.
1. Medical need sharing
The primary way you may receive direct medication assistance from your health share is if you receive a prescription in relation to a shareable medical need or event (illness, injury, surgery). The vast majority of health share companies are willing to share in medications you need to help you with a shareable need. There are two main categories of prescriptions you may get help with:
- Inpatient medications
- Post-event medications
Inpatient scripts are for medications you might receive while undergoing treatment in the hospital. This could be something like pain management after an emergency or accident. Pretty much every health share will help you with these types of prescriptions since it is in line with the main purpose of a health share: helping with major, unexpected medical situations.
Once you leave the hospital, your doctor may prescribe medications to help your recovery. For example, you may need a course of antibiotics after surgery. Most health shares will also cover these medications to some extent. The standard shareable amount is 120 days after the medical event. However, some ministries will only share 45, and others limit sharing for post-event medications to their highest-tier plan. Still others, like Altrua, may share medications needed at the hospital but they do not outline specifics (this means they can determine what is medically necessary for your specific case).
2. Prescription discounts
Although your health share may not assist directly with the costs of your routine prescriptions, they should help you find discounts. In fact, if your health share does not offer some means of obtaining discounted prescriptions, that is cause for concern. Every health share reviewed by this site offers some way for their members to get discounted prescriptions. Of course, some health shares have better partners than others.
The least a health share can do is provide their members access to a discount prescription card or some other program that makes discounted medications readily available. This might be thought a popular company like GoodRx, or an in-house service provided by the health share. Your best possible discounts will come on routine generics that may cost as low as $10 for a thirty-day supply.
3. Maintenance medication sharing
While you should expect prescription discounts, you should not expect your health share to actually share in your routine medication costs. Meaning, your community will likely not pay for maintenance prescriptions. There are a couple of exceptions.
Since so many members are interested in prescription assistance, some companies are taking notice, and coming up with solutions. For example, Zion HealthShare has partnered with OptumRx to create the RxShare program. This program allows you to “share” the cost of your prescriptions for a low copay, which ranges from $5 to $15 for generic prescriptions.
Other companies are softening the edges of their prescription sharing limits. For example, Solidarity recently started sharing in the cost of maintenance medications for diagnosed mental health conditions. In this case, Solidarity is extending the reach of need-related or post-event medication sharing. This is good news for members like you because this shows recognition that some medical events require ongoing care—and that medication may play a critical role in that care.
You can’t expect your health share to pay for all of your medications. What you can expect is significant help for anything you might need in a major medical situation. In addition, you will absolutely have access to reasonably priced generic medications. Hopefully, in the future, we will see more companies share in maintenance medications.