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Mail-order meds can sometimes be tough to swallow

Does having your medication mailed to your door sound appealing? Expecting to cut costs, more than one-third of respondents in a 2013 Consumer Reports survey got at least some of their prescriptions through a mail-order pharmacy in the previous 12 months.

The discounts are often significant, especially for drugs people take regularly, like those for diabetes or high blood pressure, Consumer Reports says. Depending on your insurer’s pharmacy-benefit manager (who buys in bulk from manufacturers and passes along the savings), you might be able to order a three-month supply of some drugs for a co-payment of just a few dollars. In some cases, you might be eligible to get some generic medications for a $0 co-pay, including free shipping. Plus, there’s no need to go to a drugstore.

Sounds like a great deal, doesn’t it? It certainly can be – but not always. Here are the pluses and minuses:

• Not all medications should be mail-ordered. Because mail programs usually ship a 90-day supply at a time, they’re ideal for drugs used on an ongoing basis, not those you need immediately or briefly. And some drugs, like some for pain and insomnia, have shipping restrictions.

• Savings aren’t guaranteed. Before ordering, see what your insurer’s plan will charge for mail-ordering and shipping your meds. Consumer Reports suggests checking your local pharmacy’s prices, too; many now offer 90-day prescriptions with low co-pays. And chain and big-box stores have many generics at deep discounts. Kmart, Sam’s Club, Walgreens and Wal-Mart, for example, offer a 90-day supply of dozens of generics for only $10, usually including free shipping but also, in some cases, a membership fee.

• You might have to request generics. Mail-order pharmacies are sometimes slow to make generics available, but that gap has narrowed. To ensure you don’t get stuck with a pricier brand-name drug, ask your doctor to prescribe a generic and to state it clearly on the prescription.

• You might need two prescriptions to start. To ensure you’ll have enough medication while you wait for your insurer to process your new order, which can take up to two weeks, ask your doctor for a 30-day prescription to be filled right away at a local pharmacy and a 90-day mail-order prescription.

• Keep your pharmacists in the loop. It’s best to fill all prescriptions at one pharmacy so your pharmacist can alert you to possible drug interactions, recalls and more. If you get regular medications via mail-order and drugs you need occasionally at a walk-in pharmacy, let each one know all of the medications you’re taking and update them regularly about any changes.

• Automatic refills can be useful, but if you know you’ll be taking a medication at a set dosage for a long time, consider getting automatic refills so you don’t have to renew that prescription every three months. But if you stop taking the drug or your dose changes, you might have to inform the mail-order pharmacy. Otherwise, you might get drugs you don’t need.

Consumer Reports says to ask your insurer whether its service will alert you before shipping medication. (Medicare Part D drug plans require mail-order pharmacies to get the OK from a patient or caregiver before shipping a new prescription or refill).

• Timing can be tricky. Because medications might not always arrive on time, make sure you set up orders online or over the phone at least two weeks before you’ll run out if you don’t have automatic refills.

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