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How to Lower Your Medicare Drug Costs
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How to Lower Your Medicare Drug Costs

By Greg Dill

Driving near Monterey, Calif., recently, I stopped at a roadside stand to buy some freshly-picked strawberries. May is high season for California strawberries, and the fields were exploding with beautiful, ripe fruit.

The gentleman working the stand, Jack, asked what I do for a living. When I told him I work for Medicare, he said he was having difficulty paying for his prescription drugs. So we talked for a while about ways he might be able to reduce his drug costs.

If you have Medicare and you’re having trouble paying for prescription drugs, signing up for Medicare’s Part D prescription drug coverage may help, even if you have to pay a late-enrollment penalty.

There are other ways you may be able to save. Consider switching to drugs that cost less. Ask your doctor if there are generic, over-the-counter, or less expensive brand-name drugs that could work just as well as the ones you’re taking now.

Switching to lower-cost drugs can save you hundreds or possibly thousands of dollars a year. Visit the Medicare Plan Finder at Medicare.gov/find-a-plan to get information on ways to save money in your Medicare drug plan. Or call 1-800-MEDICARE (1-800-633-4227) and ask our customer service representatives.

You may also be able to lower your Medicare prescription drug costs by:

  • Exploring national- and community-based programs that may help you with your drug costs, like the National Patient Advocate Foundation or the National Organization for Rare Disorders. Get information on federal, state, and private assistance programs in your area on the Benefits Check Up website at benefitscheckup.org. The help you get from some of these programs may count toward your true out-of-pocket (TrOOP) costs. TrOOP costs are the expenses that count toward your Medicare drug plan out-of-pocket expenses—up to $4,950 in 2017. These costs determine when your catastrophic coverage will begin.
  • Looking into Manufacturer’s Pharmaceutical Assistance Programs (sometimes called Patient Assistance Programs) offered by the makers of the drugs you take. Many major drug manufacturers offer assistance for people enrolled in a Medicare drug plan.

Find out whether the manufacturers of the drugs you take offer assistance by visiting Medicare.gov/pharmaceutical-assistance-program or calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. Such assistance programs aren’t part of Medicare Part D, so any help you get from this type of program won’t count toward your TrOOP costs.

  • Applying for Extra Help paying for your Medicare prescription drugs. If you have Medicare and have limited income and resources, you may qualify for Extra Help. To apply for Extra Help, contact Social Security by visiting socialsecurity.gov/i1020 or by calling 1-800-772-1213. TTY users should call 1-800-325-0778. Extra Help can save you thousands of dollars on drug costs.

If you need help finding resources like the ones described above, call your State Health Insurance Assistance Program (SHIP) and ask for free personalized counseling for people with Medicare.

To get the phone number for your state’s SHIP, visit shiptacenter.org, or call 1-800-MEDICARE.

And if you’re wondering whether Jack charged me for the strawberries, he did offer them for free. But since helping people with Medicare is a big part of my job, I told him I preferred to pay despite his kind offer.

We settled on a fair price, along with some freshly baked shortcake.

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