The Savings Game: How to Lower Your Prescription Drug Costs

By Elliot Raphaelson
From Tribune Content Agency

Medicare recommends five ways for you to reduce your Part D prescription expenses. These are the main points and I will add one more.

Consider Switching to a Generic Prescription

If you have a costly name-brand prescription, ask your doctor for a generic option that meets your requirements. A mail-order pharmacy may be able to reduce your cost.

Find Additional Medicare Coverage for Your Drug Plans

When you are in the drug coverage gap the price of medications will increase. You may find a plan to reduce your gap costs. You must determine whether the higher premium is worth it. A website run by the Centers for Medicare & Medicaid Services allows you to explore different plans and find one that suits your needs.

Check if your drug manufacturer has a pharmacy assistance program

Many companies offer financial assistance programs that can help you reduce costs. Readers who have used Dexilant and Eliquis found that they had significant savings. To find out if your costly drugs are eligible for assistance, contact your manufacturer. Medicare.com has a page to help you with your keyword search.

Take Advantage of the State Pharmaceutical Assistance Program

Medicare.gov will help you locate information if there is an assistance program to lower your drug prices.

Apply to Additional Help

Medicare offers assistance to families that have limited financial resources. It also allows them to reduce their drug costs. To find out more, go to www.medicareinsurance.com/what-is-medicare-extra-help. Eligibility will be determined by your income and financial resources. Your out-of-pocket costs and sometimes even your total cost for the drug will be decreased if you’re eligible.

The income limits in 2022 for an individual was $20,385; for a married couple the limit was $27,465. For financial resources, the limit in 2022 for an individual was $14,610; for a married couple, the limit was $27,465. These resources include money in savings or checking accounts as well as stocks and bonds. What don’t count are your home value, one car, burial plot, up to $1,500 for burial expenses, furniture or other household items. According to the Social Security Administration (SSA), the value of these benefits can be up to $5,000.

You can either apply by hand, at the local SSA office or via phone. You can call 1-800-772-1213 to apply by phone or obtain more information. The representative who answered the phone confirmed that you can apply by telephone for the program.

Apply to a Prescription Exemption

Many readers suggest that the “prescription exemption” has helped them reduce their Part D drug costs.

Let’s say you want to be prescribed a drug which is either too costly for your Part D or not available through your Part D. Your doctor may be able to provide documentation proving the need for that drug. This could indicate why a cheaper alternative is more effective. You can request an exception with Part D by providing this documentation from your doctor. One reader indicated that, using this process, the monthly cost of her Eliquis prescription was reduced from $700 per month to $48.

Details of program can be found at the Centers for Medicare & Medicaid Services website CMS.gov. Search on terms “CMS prescription exceptions.”

(Elliot Raphaelson welcomes your questions and comments at [email protected]. )

(c)2022 Elliot Raphaelson. Distribution by Tribune Content Agency, LLC.

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