Medicare Your Coverage Options

Six tips for keeping your drug costs down if you have Medicare

Written by Diane Archer

Many people with Medicare find that they are paying a hefty amount for their drugs, even with prescription drug coverage. Drug companies have considerable power to set high prices for many drugs; insurers have little power to rein them in. Instead, insurers shift costs onto members who need high-cost drugs. That helps explain why government drug price negotiation was the top policy issue in a 2015 poll of likely voters.

Whether you are enrolled in a Medicare Part D prescription drug plan or a Medicare HMO or other private Medicare plan, copays or coinsurance for some drugs can be extremely high. There’s no magic fix. But, help with these costs may be available. Here are six tips for keeping your costs down:

  1. Review the drugs you’re taking with your doctor:  Your primary care doctor might be able to shorten the list of drugs you’re taking and, in the process, save you money. If you’re taking high-cost brand-name drugs, your primary care doctor might also be able to prescribe you lower-cost generic drugs. Generics must have the same active ingredients, same strength and purity and same effect. Check out Consumer Reports Best Buy Drugs to learn about how to lower your prescription drug costs.
  2. Ask your Part D drug plan or private Medicare plan about reducing your copay: If your drug is in the highest tier—requiring a very high copay–the plan might reduce the copay if your doctor can demonstrate that you have no other drug alternative for your condition that safely meets your needs.
  3. Extra Help: If your monthly income is under $1,471 (individual) or $1,991 (couple) and your assets are below $13,070 (individual) or $26,120 (couple), you may qualify for the Extra Help program that pays for some or all of your drug coverage. And, if you qualify for Medicaid, your drug costs drop significantly.)
  4. State Pharmaceutical Assistance Programs: In some states, state pharmaceutical assistance program provide help with the cost of drugs. Contact your State Health Insurance Program to find out about any drug benefits your state provides. Call 1-800-677-1116 or visit www.eldercare.gov
  5. Drug company assistance programs: Some drug companies offer people reduced prices for their drugs in some cases. Contact the Partnership for Prescription Assistance or NeedyMeds to find out if you qualify for help with your drug costs.
  6. Online pharmacies: You can often find significantly lower-priced drugs through online pharmacies. And, increasingly, people are using international online pharmacies to keep their costs down. Kaiser Health News reports that some 19 million people in the U.S.–eight percent of Americans–now buy their drugs outside the U.S. to afford them. But, people must be careful they are using a legitimate pharmacy and not an outfit selling counterfeit or expired drugs. Also, it is technically illegal to import drugs from abroad, although it appears that no one has been prosecuted for doing so for personal use. Here’s what to consider.

Keep in mind: If you’re a Vet, you likely can get low-cost drugs through the Veterans’ Administration.

You can also save money on your prescriptions if you’re abroad.  Speak with your doctor first. But, if you’re traveling out of the country, consider buying your drugs while you’re away. Almost any place you visit has drug prices at a fraction of the cost you pay here. 

To learn about other ways you can lower your health care costs, click here. And click here for information about free local resources.

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6 Comments

  • KILL THE “DONUT HOLE”. When non generics are non existent, it’s discriminatory, cruel and inhumane considering epidemic ailments such as diabetes, heart and stroke, etc.

    • You are absolutely correct. Inhumane and predatory are the basic tenets of American greedy healthcare system. Big Pharma leads the way. Americans have been brainwashed for so long,they came to accept it as status quo.

  • What are the pharmaceutical investments of Tennessee state representatives and senators and our congressman and senators and Washington?

  • I was told by my pharmacy that if Medicare-D paid even a few cents on a medication, no drug company assistance program would apply. Medicare effectively prevents you from taking any advantage of drug company offers. Talk about catch-22.

    • 1. Done that, got a new prescription for yet another pill
      2. Per my doctor this is just a way to get you off the phone, he has tried this and it never works
      3. My income is too high
      4. Not in Texas
      5. Doesn’t work if you are one Medicare
      6. I’m not a vet

  • Remember when George W Bush lied to everyone when Medicare Part D was passed, he said that we would never have to worry about drug prices again because big pharma would always be fair on pricing. Interestingly, that’s when drug pricing explode and the pockets of the average person’s pockets got picked legally

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