Good morning. August is doing that thing where the days are still long but you can feel September in the shadows.

In this issue:

THE BIG STORY

The average American over 65 takes 4.7 prescription medications. That's according to the CDC. And most of us pick them up the same way every month — walk in, wait, sign, leave. The only question: "Is it ready?"

Here's the one question your pharmacist wishes you'd ask: "Is there a cheaper alternative that does the same thing?"

Pharmacists can often suggest generic versions, therapeutic alternatives, or manufacturer discount programs you didn't know existed. They went to school for this. They're standing right there. And unlike your doctor's office, there's no copay to ask.

Why this matters: A single brand-to-generic switch can save you $50-200 per month, per medication. Multiply that across 4.7 prescriptions and you're looking at real money.

Two more questions worth keeping in your back pocket: "Do any of my medications interact with each other?" and "Should I be taking this with food?" You'd be surprised how many people take medications incorrectly for years without knowing.

Most pharmacies — Walgreens, CVS, independents — offer free medication reviews. You don't need an appointment. Just ask. Even better: do a brown bag review once a year. Put every medication you take (including OTC stuff, vitamins, supplements) in a bag and bring it to your pharmacist. They'll check for interactions, duplicates, and anything you might not need anymore.

Medicare Part D's new $2,000 annual out-of-pocket cap helps, but asking the right questions can save you money before you even get close to it.

Schedule a free medication review at your pharmacy →

WORTH KNOWING

🩺 Your blood pressure monitor might be lying to you. Not all home monitors are created equal — the FDA doesn't test them for accuracy. Some are off by 10+ points, which is the difference between "normal" and "go to the doctor." Nino C. wrote a full guide on which monitors are actually validated and how to use them correctly. If you're checking at home, this is worth five minutes.

→ Read the full guide

💉 Get your updated COVID and flu shots this fall. The 2025-2026 flu vaccine and updated COVID boosters will be available in September. Both are free under Medicare Part B — no copay, no deductible. The takeaway: Don't wait until you're sick. Antibodies take about two weeks to build, so mid-September is the sweet spot. Mark your calendar now.

🏥 Urgent care vs. ER: know before you go. The average ER visit costs $2,200. Urgent care averages $200. If it's not chest pain, trouble breathing, severe bleeding, or stroke symptoms — urgent care is probably the right call. Many Medicare Advantage plans cover urgent care with a $20-50 copay. Keep your insurance card and a list of your medications in your wallet. You'll thank yourself later.

FROM THE ARCHIVES

The 4 AM Book Club: What Reading Means After 70 — by Victoria Sinclair

This is one of my favorite pieces we've published. Victoria — who taught English for 34 years and has been in the same book club for 22 — writes about what reading means when you're not trying to get ahead anymore. You're just reading because you love it.

She rereads The Great Gatsby at 72 and cries. Not about Gatsby. About Nick. About going home to the Midwest when the party's over. She writes about her 4 AM reading hour, her husband Frank who won't touch a novel, and a Word document on her laptop called "Chapter1_FINAL_v3.doc" that she opens once a year.

It's warm, it's funny, and it's the perfect thing to read on a summer afternoon with nowhere to be.

Read the full article →

SLICE OF LIFE

My pharmacist knows my name, my medications, and my dog's name. She doesn't know I only go to that CVS because it's next to the donut shop. Some things are between me and the donuts.

Until next Tuesday,
Nino

P.S. If someone you know takes a handful of pills every morning and hasn't talked to their pharmacist about it — forward this their way. And hit reply if you want. I read every one.