Many people with Medicare find that they are paying a hefty amount for their drugs, even with prescription drug coverage. Drug companies have considerable power to set high prices for many drugs; insurers have little power to rein them in. Instead, insurers shift costs onto members who need high-cost drugs. That helps explain why government drug price negotiation was the top policy issue in a 2015 poll of likely voters.
Whether you are enrolled in a Medicare Part D prescription drug plan or a Medicare HMO or other private Medicare plan, copays or coinsurance for some drugs can be extremely high. But, help with these costs may be available. Here are six tips for keeping your costs down:
- Ask your Part D drug plan or private Medicare plan about reducing your copay: If your drug is in the highest tier -- requiring a very high copay -- the plan might reduce the copay if your doctor can demonstrate that you have no other drug alternative for your condition that safely meets your needs.
- Extra Help: If your income is under $1,471 (individual) or $1,991 (couple) and your assets are below $13,070 (individual) or $26,120 (couple), you may qualify for the Extra Help program that pays for some or all of your drug coverage. And, if you qualify for Medicaid, your drug costs drop significantly.)
- State Pharmaceutical Assistance Programs: In some states, state pharmaceutical assistance program provide help with the cost of drugs. Contact your State Health Insurance Program to find out about any drug benefits your state provides. Call 1-800-677-1116 or visit www.eldercare.gov
- Drug company assistance programs: Some drug companies offer people reduced prices for their drugs in some cases. Contact the Partnership for Prescription Assistance or NeedyMeds to find out if you qualify for help with your drug costs.
- Veterans' Administration: If you're a Vet, you likely can get low-cost drugs through the Veterans' Administration.
- Save money abroad: If you're traveling out of the country, consider buying your drugs while you're away. Almost any place you visit has drug prices at a fraction of the cost you pay here.