Managing medications can be difficult when the cost of your drugs is high. If you’re having trouble paying for your prescriptions, here are a few options you may have to save money.
- Talk to your doctor—and your plan. When you’re prescribed a new medication, you should check to see whether it’s on your plan’s formulary (approved drug list) and how much your copayment is. If your drug plan doesn’t cover your prescription, or if your copayments are very high, ask your doctor for help. Physicians will know whether there are comparable, less expensive drugs (e.g., generics) that may be available to you; some may even be able to provide free samples of medications while you seek other coverage options. Doctors can also request an exception to ask your plan to cover the medication, or to pay at a lower tier.
- See if you can get for Extra Help. The Medicare Part D program has a subsidy called Extra Help that assists people with limited income and resources pay for their drugs. If you get Extra Help, you’ll save money on your drug plan premium, deductible, and at the pharmacy—with prescriptions costing under $10. See if you qualify and apply online today.
- Check with your state. About half of the states have State Pharmaceutical Assistance Programs (SPAPs) to help people with pay for their prescriptions. Many SPAPs work with Medicare Part D, “wrapping around” coverage, meaning they help pay for certain costs that Part D does not cover. However, each state runs its program differently, so it’s best to check what the rules are in your area. Find out whether your state has an SPAP.
- Find help from drug manufacturers. Patient Assistance Programs, or PAPs, are programs offered by drug companies that help people pay for their drugs. Through these programs, many drug manufacturers offer the drugs they make for free, or at a discount. Some PAPs are for people who don’t have insurance, while a few help people with Medicare Part D who don’t qualify for Extra Help. Our BenefitsCheckUp® screening tool can help you see whether you can get help from a PAP—or any of the other programs mentioned on this page.
- Discover drug charity programs. Several national charity programs exist that can help people with Medicare afford their medications. Many of these specifically focus on assisting people with chronic conditions and rare diseases. Get a list of programs and links to their eligibility criteria.
- Don’t forget Open Enrollment! Every year from Oct. 15 to Dec. 7, people with Medicare can switch their prescription drug plans for the following year. If you’re having trouble with your drug costs, it’s a good idea to compare plans to see if there’s a more affordable option. You can go online at any time to compare plans using the Medicare Plan Finder, or you can get personalized help from your State Health Insurance Assistance Program (SHIP). Every state has a SHIP that offers free, objective, and personalized information to people with Medicare. You can also ask your SHIP whether you qualify for a Special Enrollment Period to switch plans. Find your SHIP.