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Even with insurance, many people living with chronic conditions have challenges paying for the meds they need, especially if they have multiple prescriptions or changing medication schedules.

According to the Health Policy Institute at Georgetown University, more than 66 percent of all adults in the United States — more than 131 million people — use prescription drugs. Usage is particularly high for older adults and those with chronic conditions.

About half of those taking medications pay some portion out of pocket, and concern about cost is one of the top factors for why people take less medication than prescribed or sometimes skip meds altogether.

This is a dangerous strategy, since it can exacerbate symptoms — or worse.

A 2012 review estimates that lack of medication adherence is a direct cause of 10 percent of hospitalizations every year, and causes nearly 125,000 deaths annually.

A frequently-prescribed and notoriously expensive drug like insulin is a top example.

One recent survey from Diabetes Daily reports that 44 percent of respondents with diabetes struggled to afford insulin, nearly 68 percent altered their insulin dosage to save money, and 48 percent cut back on basic necessities like food and rent to be able to afford insulin.

With economic uncertainty and potential changes in treatment due to COVID-19, sticking to a medication regimen may be even more challenging for some people moving forward.

Fortunately, with all types of medication, there are resources that can help — either by providing medications directly, or by lowering costs or the financial impact of prescriptions.

If you’re struggling to pay for your prescriptions, consider these tips.

Many people believe they automatically have to use their health insurance when getting prescriptions, and that the copay amount represents the best price for a medication.

That’s not always true, says Jessica Nouhavandi, PharmD, lead pharmacist and co-CEO of online pharmacy Honeybee Health.

“Copays can often be much higher than the true cost of the medication,” she says. “You may be able to save significantly by skipping insurance altogether and paying out of pocket for your prescription medications instead.”

Take the time to do some comparison shopping, she suggests, either by calling local retail pharmacies and asking about prices, looking at online pharmacies, or doing both.

A little research on price differences could add up to big savings.

Although Honeybee Health has a wide range of medications, it’s certainly not the only option.

There are numerous online pharmacies staffed by pharmacists and just as legitimate as retail locations. However, as with other online companies, there are imposters, too.

The Food and Drug Administration (FDA) has an online database with links to state licensing agencies so you can double-check that a pharmacy is legit.

The FDA recommends finding an online pharmacy that requires a valid prescription from your doctor, has a physical address and telephone number in the United States, and has a licensed pharmacist to answer your questions.

A resource that was specifically set up to help people who struggle to afford medication is Dispensary of Hope, an organization that has pharmacy partners around the country.

Alex Evans, PharmD, a medical writer and pharmacist based in Florida, says that with the help of Dispensary of Hope, his partner hospital has been able to get a wide range of medications to patients at no cost to them, including insulin in some cases.

“While branded medications are not included, you can get generic medications for free if you qualify,” says Evans. “This is truly one of the most commonly overlooked and little-known resources when it comes to medication affordability.”

Other charitable organizations that help with medication costs include:

Being unable to afford an expensive medication should never be a source of embarrassment, and talking about cost can be a very helpful way for your healthcare provider to assess your medication needs, says Aaron Emmel, PharmD, founder of, an online pharmacy technician education program.

“The first step before pursuing medication assistance options, in my opinion, is to ask your provider about more affordable options,” he says.

“Prescribers can get in the habit of prescribing the latest and greatest medications that may not necessarily have significant advantages over older, cheaper, and better-established treatments,” he adds.

Emmel recommends having a discussion with your pharmacist as well.

Both providers and pharmacists are often aware of other assistance options, such as programs run by drugmakers, samples that are available to patients, coupon programs like discount apps, and more.

One tactic that isn’t recommended, under any circumstance, is to play around with dosage and medication frequency as a way to cut costs.

Making healthy lifestyle changes — such as exercising more and lowering carbs to reduce the need for insulin — is a great step, but experts emphasize you shouldn’t tweak medications on your own.

Instead, talk with your healthcare team and make a plan that gets you what you need, without breaking the bank.

Elizabeth Millard lives in Minnesota with her partner, Karla, and their menagerie of farm animals. Her work has appeared in a variety of publications, including SELF, Everyday Health, HealthCentral, Runner’s World, Prevention, Livestrong, Medscape, and many others. You can find her and way too many cat photos on her Instagram.