You can try to pick the generic options and shop around at different pharmacies, but prescription medications can be costly even with a prescription drug plan. If you need help with prescription drug costs, look to the specialized pharmaceutical assistance programs in your state.
Get Coverage for the Gap
One of the concerns with Medicare Part D is that once you have spent over a certain amount ($4,660 in 2023) for prescriptions, your insurance stops paying until you reach catastrophic coverage (spend $7,400 in 2023). Those thousands of dollars are no laughing matter for people on a fixed income, which is why some Medicare Part D plans have additional coverage for costs during the coverage gap. If this is a concern for you, seek out a plan with this coverage.
Apply for a Pharmaceutical Assistance Program
You’ve probably heard it at the end of a prescription drug commercial: “If you can’t afford the cost of your prescription, [X Company] may be able to help.” It’s possible that the makers of the medications you take offer savings cards or programs that can dramatically lower the cost of your prescription. You may need to provide information such as your name, date of birth, insurance plan and contact info. If you have sticker shock at the pharmacy counter, ask the pharmacist if a program may be available.
Check for Your State Pharmaceutical Assistance Program
Medications are expensive everywhere, which is why several states have programs in place to offer aid to residents who cannot afford their prescriptions. The Medicare website can help you navigate to your state’s pharmaceutical assistance program website.
Apply for Extra Help
Medicare has a specific program dedicated to helping people with low incomes and limited resources to pay for the costs of their prescription medications. In 2023, prescription drug costs for people with Extra Help will pay a maximum of $4.15 for a generic medication or $10.35 for brand-name drugs.
People with Medicaid automatically get Extra Help, as do beneficiaries whose Part B premiums are covered by a Medicare Savings Program and people who have been receiving Supplemental Security Income from Social Security. If you don’t fall into one of those groups of people, you can apply through the Social Security website.
Take Advantage of Your Resources
If you are concerned about your prescription drug costs, work with your insurance agent to see what available plans may better suit you. Give Magellan Healthcare a call today to get started.
