Written and medically reviewed by Dorcas Morak, Pharm.D
Medicare Part D is the federal government health insurance plan that covers prescription medications. Whether you’re newly enrolled or have been on a plan for a while, managing out-of-pocket medication costs can be challenging. Prescription medication expenses can pile up, sometimes costing thousands of dollars a year. Fortunately, several strategies and resources are available to help you save money on your prescriptions.
Tips for Seniors on Saving Money through Medicare
Below are various tips for seniors on saving money through Medicare:
Check State Resources
Your state may offer programs to reduce your prescription medication costs. Contact your local Department of Aging for help finding the best Medicare plan for your needs. Many states have cost-saving programs for older adults. For instance, Pennsylvania runs PACE and PACENET, which offer low-cost prescription medications to those who qualify.
Use the Medicare search tool to see if your state has a State Pharmaceutical Assistance Program. These programs help residents pay for prescription medications and can be valuable resources for managing medication expenses.
See if You Qualify for the Extra Help Program
The Extra Help/Low-Income Subsidy program is a federal initiative to reduce out-of-pocket costs for people on Medicare Part D by limiting deductibles and copays. To qualify, your income and assets must be under a specific limit. Starting January 1, 2024, most eligible people saw significant savings on Part D prescription medication costs:
- No monthly premium for Medicare Part D
- No Medicare Part D deductible
- Low copays: $11.20 or less for brand-name medications and $4.50 or less for generic medications
For those enrolled in both Medicare and Medicaid with income at or below 100% of the federal poverty level (FPL), the copays are even lower:
- $4.60 per brand-name medication
- $1.55 per generic medication
If you meet specific eligibility criteria, you automatically qualify for Extra Help. If not, apply online through Social Security or call 1-800-772-1213 (TTY users: 1-800-325-0778) to apply over the phone.
Learn More About Patient Assistance Programs
Private pharmaceutical companies or nonprofits run patient assistance programs (PAPs) to help uninsured or low-income people get their medications at little or no cost. These programs require you to meet specific qualifications and complete paperwork, mainly for brand-name medications. For example, Novo Nordisk’s Patient Assistance Program offers free medications, including various diabetes drugs, to those who qualify. To be eligible, you must:
- Be a U.S. citizen or legal resident
- Have a total household income at or below 400% of the FPL
- Have Medicare or no insurance
- Not be enrolled in Medicaid, Medicare’s Extra Help, VA benefits, or other government programs
You can generally apply for PAPs online, by mail, or by fax, and you typically need to include proof of income, tax documents, and a form filled out by your healthcare provider. Use Medicare’s search tool to find a Pharmaceutical Assistance Program for your prescription medications.
Use Generic Prescription Medications When Available
Switching to generic prescription medications can significantly lower your costs under Medicare Part D. Generics have the same active ingredients, dosage, and quality as brand-name medications but cost 80% to 85% less.
Part D plans categorize medications into tiers, with lower tiers having lower copays. Generics are almost always in tier 1, with most having a copay of less than $20. Unlike brand-name drugs in higher tiers, switching to generics generally reduces your out-of-pocket expenses.
Shop Around for the Best Price and Discounts
Join the RxLess Assurance Plan by downloading our free app or use the RxLess website to compare prices across different pharmacies. RxLess offers prescription savings cards and coupons that can save you up to 88% off the retail price of generic medications. While these discounts cannot be combined with Medicare, the prices found on RxLess are often better price than your Part D plan and offer discounts on medications not covered by Medicare Part D.
