Battling the Rising Costs of the Medicare Part D Drug Program and 4-Strategies to Save Money

Medicare coverage for your health care needs is a magnificent program, yet medication costs can still be staggering for seniors who need prescription drugs that either aren’t covered by their Medicare Part D plan or are still prohibitively expensive despite their coverage. In this blog, I am going to share ideas on the various ways you can examine that may bring down your medication costs.

4 Ways to Save Money on Medications

  1. Look for coupons and discounts.

Coupon sites can save you up to 80% on the cost of prescription drugs. Anyone can use these coupons regardless of whether they have insurance or not—and this is true if you have commercial insurance, Medicare, Medicaid, or any other type of insurance. 

https://www.goodrx.com/

https://www.blinkhealth.com/

  1. Look into pharmaceutical assistance programs.

California does NOT have a State Pharmaceutical Assistance Program (SPAP), but some pharmaceutical companies offer assistance programs for the drugs they manufacture. These programs are designed to assist persons who cannot afford the high cost of prescription drugs and do not qualify for “Extra Help” but meet other eligibility guidelines. Income thresholds for these programs are generally much higher than state or federal assistance programs.

www.medicare.gov/pharmaceutical-assistance-program/

  1. Review your eligibility for state or federal assistance programs.

Government entities can provide assistance programs to help seniors out with the cost of their medications if they meet the income and eligibility qualifications.

Extra Help – (LIS) Rx Assistance

What is Extra Help?

A Medicare program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance. Extra help is a Federal assistance program and is not the same as Medi-Cal.

https://www.ssa.gov/benefits/medicare/prescriptionhelp/

Medicare Savings Programs (MSP)

There are 4 kinds of Medicare Savings Programs

    • Qualified Medicare Beneficiary (QMB) Program
    • Specified Low-Income Medicare Beneficiary (SLMB) Program
    • Qualifying Individual (QI) Program   
    • Qualified Disabled and Working Individuals (QDWI) Program

If you qualify for the QMB program, SLMB, or QI program, you automatically qualify to get Extra Help paying for Medicare prescription drug coverage.

https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs

  1. Consider ordering your drugs from Canada.

The Canadian MedStore can help you get your prescription medications safely delivered to your door for up to 70% less than US prices. Many expensive brand name drugs are available as generics at a much lower cost through International pharmacies. Medication purchased from an International pharmacy is not included in the calculation toward the donut hole, but these two programs together can provide a complimentary relationship to maximize your prescription drug benefits.

http://www.drugstoreunlimited.com/

The GAP, known universally as the “doughnut hole,” is the most criticized and unpopular part of the Medicare prescription drug program.

Determine What Goes Toward the ‘Doughnut Hole’

In Medicare Part D, when your annual drug costs (not including premiums) reach $4,020 (in the year 2020), you enter the so-called doughnut hole.

See If You Can Save by Paying Cash

In our analysis, we found that our sample drugs were sometimes less expensive using a GoodRx coupon than with insurance.

Finding the perfect balance of steering clear of the donut hole and getting the lowest prices on drugs is a strategy that a good licensed agent can help you determine. In many instances the best choice is to fill all high cost drugs through the plan and take the higher out of pocket hit in the first few months of enrollment because If you reach the Catastrophic Coverage Phase, you will pay significantly lower copays or coinsurance for your covered drugs for the remainder of the year.

For Questions and to Learn More, Call 858-391-8544

This blog is an opinion piece and is not associated, endorsed or authorized by the Social Security Administration, the Department of Health and Human Services or the Center for Medicare and Medicaid Services. Medicare has neither reviewed nor endorsed this information.