How Can I Lower the Costs of My Prescription Drugs?
If you’re like many people who take medications to manage health conditions, you may be concerned about the costs of prescription drugs. As a Medicare beneficiary, you might have some ways to get lower prescription drug prices.
Medicare Part D may help with the costs of prescription drugs
One way to get some help with costs of prescription drugs when you’re on Medicare is to sign up for coverage under Medicare Part D. That’s prescription drug coverage available through private insurance companies that contract with Medicare.
Under a Medicare Prescription Drug Plan, costs associated with your prescription drugs will generally include the copayment or coinsurance amount for each covered medication. Some plans may charge a monthly premium, and some also have annual deductible amounts.
You can get this coverage in two main ways:
- Through a Medicare Advantage Prescription Drug plan
- Through a stand-alone Medicare Part D Prescription Drug Plan
Read more about these plan types, including their differences and similarities: Medicare Part D Coverage – Medicare Advantage or a Stand-Alone Plan?
The costs of prescription drugs may vary among plans
Prescription drug prices aren’t always the same from one Medicare Part D Prescription Drug Plan to another. It really might be worth your while to shop around. According to a 2017 eHealth study, more than 90% of eHealth shoppers may be able to find lower-priced Medicare Prescription Drug Plans than they currently have.
You may be able to change plans to help lower the costs of your prescription drugs
You can switch from one Medicare Prescription Drug Plan to another as long as you’re eligible for your plan of choice and live within the plan’s service area. Medicare has an Annual Election Period once a year, from October 15 – December 7. During that period, you can generally do any of the following (and more):
- Change from one Medicare Advantage plan to another.
- Change from one stand-alone Medicare Part D Prescription Drug Plan to another.
- Change from a stand-alone Medicare Part D Prescription Drug Plan to a Medicare Advantage Prescription Drug plan. You do this by changing from Original Medicare (Part A and Part B) to a Medicare Advantage Prescription Drug plan, and dropping your stand-alone plan.
- Change from a Medicare Advantage plan to Original Medicare (Part A and/or Part B). During this enrollment period, you can then enroll in a stand-alone Medicare Part D Prescription Drug Plan.
- Sign up for a stand-alone Medicare Part D Prescription Drug Plan.
This is not a complete list of coverage changes you can make during this time.
What if I still have trouble with the costs of prescription drugs?
Depending on your situation, you might be able to get help with your Medicare prescription drug prices.
- If you have a Medicare Prescription Drug plan, and you and your plan spend a certain amount on your medication costs within a calendar year, you’ll reach the “coverage gap” (also called donut hole) where your prescription costs may be different. Then, if your prescription drug costs reach an even higher level, you may reach the “catastrophic coverage” category, where you’d only have to pay a small amount for each medication for the rest of that year.
- You can file a Medicare appeal to try to get lower prescription drug prices. Click here for more information.
- If you have a low income or no income, you might be able to get help with the costs of your prescription drugs through your state Medicaid program. Click here for a list of Medicaid contact numbers by state.
It’s easy to compare Medicare Prescription Drug Plans from your tablet, phone, or computer. Just enter your ZIP code in the box on this page to get started. Note that you can enter your medications from the list of plans displayed, so you can see which plans may cover your medications and for what prices.
The formulary may change at any time. You will receive notice when necessary.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/co-insurance may change on January 1 of each year.
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