Medications can be expensive, with the average adult age 65 to 79 paying $456 out of pocket for their prescriptions every year.¹ But there are public and private programs that can help you save money. 

Below, we explore ways you can spend less on the medications you need to stay healthy. You’ll also learn how to find programs to help you afford other daily expenses like groceries and utilities. 

"No one should skip medication because of the cost,” said Ryan Ramsey, NCOA Associate Director of Health Coverage and Benefits. “The fact is there are resources available that can make prescription drugs more affordable. You just have to know where to look."

What should I do if I can't afford my prescription medication?

1. Explore federal prescription assistance programs

If you or your family member has Medicare, the first benefit to consider is Part D Extra Help. This program from Social Security and Medicare helps you save money on Part D drug plan premiums and co-payments at the pharmacy. It's estimated to be worth about $5,700 per year. To get Extra Help, you must have low income and resources. Learn more from Social Security.

2. Explore State Pharmaceutical Assistance Programs (SPAPs)

Don’t qualify for Extra Help? Your state may offer prescription savings programs. About half of states have a State Prescription Assistance Program (SPAP) for people who meet certain age, disability, chronic condition, and/or income requirements. SPAPs may help pay your premiums, deductibles, or medication co-payments.

Visit Medicare.gov to find out if there’s an SPAP offered in your state. 

3. Check out your drug plan options

Sometimes you can save money on medications by shopping around for different Medicare coverage. From Oct. 15 to Dec. 7 each year is Medicare's annual Open Enrollment Period, which allows people with Medicare to join, switch, or leave Medicare Advantage and Part D plans.

Here are two ways you can find out what prescription coverage may suit your needs:

• The Medicare Plan Finder is the official tool of Medicare.gov to shop for drug and health plans.
• Contact your State Health Insurance Assistance Program (SHIP). SHIPs are federally funded to provide unbiased, one-on-one assistance to people with Medicare and their families. Find your local SHIP by calling 1-877-839-2675 or visiting the website.

4. Learn about drug manufacturer discounts

You’ve probably seen commercials for medications on TV that end with, “If you have trouble affording your medication, Drug Company may be able to help.” That assistance comes from Patient Assistance Programs (PAPs), which are run by drug manufacturers to offer free or discounted brand-name medications to consumers. PAPs may be especially helpful to those who lack insurance coverage or have significant medication costs.

Most of the major manufacturers offer PAPs and related resources for people who take their medications. For example, Pfizer’s RxPathways program connects people to insurance support, co-pay assistance, and medicines for free or at a savings. Other PAPs are offered by Novo Nordisk, AstraZeneca, GlaxoSmithKline, and several foundations that provide disease-specific assistance, such as for people with diabetes. (Note: Some of these programs may have limitations for people with other Medicare drug coverage.)

Visit Medicare.gov to find a PAP for the medications you take. You can also try:

• NeedyMeds: This allows you to search for pharmaceutical assistance programs by drug name.
• Rx Assist: This database of PAPs is searchable by drug or manufacturer name.
• GoodRx: Once you search for a medication, look under "Ways to Save" (lower down on the page) for any available assistance programs.

5. 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.

How do I know what other government benefits I qualify for?

NCOA’s free, confidential tool BenefitsCheckUp® can help you find out if you’re eligible for public and private prescription assistance programs, including Part D Extra Help. You can also explore other programs that can help you stay healthy and independent and afford essentials like groceries, utilities, taxes, housing, and more. Visit the site and enter your ZIP code to get started.

Sources

1. Georgetown University Health Policy Institute. Prescription Drugs. Found on the internet at https://hpi.georgetown.edu/rxdrugs/