Steps to lower prescription drug costs
If you use Part D of Medicare to help cover your prescription costs, Medicare suggests five ways to lower your costs.
— Switch to a generic prescription. If you’re using a name-brand prescription that is expensive — the costs of many have increased recently — ask your doctor if there is a generic alternative. You can also determine whether using a mail-order pharmacy will reduce your costs.
— Find a drug plan that offers additional coverage in the Medicare drug coverage gap. When you enter the drug coverage gap, the cost of your medications increases. There may be a plan that reduces your costs in the gap.
However, you have to determine if it carries a higher premium that outweighs the benefits. Medicare.gov, a website operated by the Centers for Medicare & Medicaid Services, has a page that allows you to explore plan options and determine if there is a one that will reduce your overall costs.
— See if your drug’s manufacturer has a pharmacy assistance program. Many manufacturers offer assistance programs, based on your financial situation, that will reduce your costs. For example, readers who take the prescription drugs Eliquis and Dexilant have found programs that reduce their costs significantly.
Contact your drug manufacturer to determine if there is an assistance program for your expensive drugs. Medicare.com also has a webpage to assist your search using the drug name as a keyword.
— Take advantage of a state pharmaceutical assistance program to reduce your drug costs. D.C. residents can save up to 75% at pharmacies; download a free card at msdc.org or call (202) 466-1800. For Maryland’s senior prescription assistance program, see marylandspdap.com or call 1-800-551-5995. The Virginia Drug Card is a free prescription assistance program for Virginia residents; see virginiadrugcard.com or call 1-866-413-9778.
— Apply for Extra Help. Medicare and Social Security offer a way for families with limited resources to get help that will reduce drug cost. Your income level and level of some financial resources will determine your eligibility.
If you are eligible for Extra Help, your out-of-pocket drug costs will be reduced, and in some cases your costs for a specific drug can be completely eliminated. To find out more, go to medicare.gov/basics/costs/help/drug-costs.
You can apply at your local SSA office or by phone. You can call 1-800-772-1213 to apply by phone or obtain more information. I called this number, and the representative I spoke with confirmed that you can apply for this program by phone.
— Apply for a prescription exception. Several readers have been successful in reducing their Part D drug expenses using the “prescription exception” process.
Suppose you wish to be prescribed a drug that is too expensive for you in your Part D plan or is currently unavailable through your Part D plan. You may ask your doctor to document the necessity of that specific drug, indicating why an alternate cheaper drug is not effective.
One reader indicated that, using this process, the monthly cost of her Eliquis prescription was reduced from $700 per month to $48.
Details of the 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 firstname.lastname@example.org.
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