If you have insurance, what you pay depends on your plan's premium, deductible, copayment and yearly out-of-pocket limit. This guide explains how insurance costs work and which questions can help you and your prescriber look at lower-cost options.
What metformin is and why it is prescribed
Your prescriber or pharmacist can confirm which metformin forms are available for your prescription.
How to check your metformin cash price.
Ask the pharmacy for the cash price of your exact prescription and tell them the form printed on your label.
Metformin prescriptions can differ in strength and form, and the label or your pharmacist shows which applies to you. Follow the directions on your prescription label, and ask your pharmacist to confirm the strength and form prescribed for you.
How insurance changes what you pay
The Medicare page on health plan costs lists the parts that add up on a plan:
- Premium: a monthly amount you pay for coverage, whether you get services or not.
- Deductible: the amount you must pay for health care or prescriptions before your plan begins to pay.
- Copayment: the amount you may be required to pay as your share of the cost for benefits after any deductible.
- Yearly out-of-pocket limit: the plan's yearly limit on your out-of-pocket costs for all medical services.
The same page says plans set their own amounts each year, and that the plan, not Medicare, decides how much you pay for the covered services you get. What you pay the plan can only change once a year, on January 1. If your costs rose, compare the new premium, deductible or copayment in your plan's renewal materials. The page also notes that your costs can be higher, or may not be covered, when you use providers outside the plan's network for non-emergency care.
Questions to ask your pharmacist or prescriber
Any change to your medicine is made with your prescriber. These questions can help you compare costs before that conversation:
- What is the cash price for the exact strength and form on my prescription, and what will I pay if I use my insurance?
- Which form, the regular tablet or the extended-release tablet, is the lower-cost option for my prescription?
- Where am I in my deductible this year, and how close am I to my yearly out-of-pocket limit?
- Is there a lower-cost option you would consider for my diabetes?
- Who on my care team can help me look into financial help if I have trouble paying?
If cost makes you want to skip or stretch doses, talk with your prescriber about the cost problem before you change how you take any medicine. Ask your prescriber's office or pharmacy whether any financial help options apply to your prescription.
What to know about metformin before you compare options
Read the medicine information your pharmacy gives you with each prescription, and ask your pharmacist or prescriber about side effects, blood sugar changes and anything that worries you. If you notice concerning symptoms, contact your clinician or seek urgent care.
Can a supplement replace metformin or lower your costs?
Supplements are not a substitute for prescribed diabetes care. The NCCIH diabetes and dietary supplements page also says most studies have limitations and lead to no clear conclusions, and that for most supplements there is no evidence of a beneficial effect on diabetes or its complications.
Safety matters too. Tell your prescriber about any supplement you add.
How to spot ‘reverse diabetes in days' marketing
Ads that promise to help address diabetes in days deserve a closer look. Red flags include claims that a product is a natural cure for diabetes or can replace your diabetes medicine, and a product should not replace prescribed diabetes treatment without guidance from your clinician.
When you see a claim, check three things: whether it promises a cure or a replacement for your medicine, whether a named study measured that exact claim, and whether the seller says clearly what the product contains. Related guides: the Ingredient Evidence vs. Marketing Claims guide and the ED salt trick ad guide.
Where to go from here
If you are comparing blood sugar products, the LipoPeak Alternatives guide looks at what works, what costs and what is free. Bring your prescription label and the questions above to the pharmacy or your next visit.
This page is general information. It recommends no product, supplement or seller.
By SterlingMedicalCenter.org Editorial Team
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