Saving Money & Medicare

How to Get Help Paying for Medications

Content modified from information provided by the NCOA (National Council on Aging)

Many of Medicare beneficiaries rely on prescription medications to manage chronic conditions and stay healthy. But affording medications can be difficult if the cost of your prescriptions is high.

If you’re having trouble paying for your prescriptions, there are some options available that you could save you money.

1. Talk to your doctor—and your Medicare drug plan. A formulary (approved drug list) is a list of prescriptions that are covered (whether it’s a Medicare Part D, Medicare Advantage Plan with drug coverage, or a private insurance plan). When you’re prescribed a new medication, you should check to see whether it’s on your plan’s formulary and how much your copayment is. If your plan doesn’t cover your prescription, or if your copayments are very high, ask your doctor for help. Physicians will know whether there are comparable, less expensive drugs (e.g., generics) that may be available to you; some may even be able to provide free samples of medications while you seek other coverage options. Doctors can also request an exception, which means they can ask your drug plan to cover the medication, or to cover it at a lower tier, which should mean a lower cost for you.
2. See if you qualify for the Low-Income Subsidy (also called Extra Help). The Low-Income Subsidy (Extra Help) is a federal program that helps people with limited income and resources pay for their drugs. If you receive this benefit in 2026, benefits can include:
   1. No plan premiums or reduced plan premiums;
   2. No deductible;
   3. No copayment more than $12.65 for each brand-name drug (or $5.10 for generic), as long as the prescription is on the plan’s formulary

Eligibility for this program is based on income and resource (asset) limits.  For 2026, an individual person is eligible if their annual income is below $24,180 and their resources (i.e. money in the bank, stocks, property other than the home they live in) are below $18,090. Couples would need to have combined annual income under $32,700 and resources under $36,100 in 2026. You can apply for the Low Income Subsidy directly through the Social Security Administration or by calling 1-800-722-1213 (TTY 1-800-325-0778). For assistance with applying, you can also contact SHIIP/ SMP at 1-800-351-4664 or find your local counselor.

3. Check with Iowa’s State Pharmaceutical Assistance Program. Iowa’s State Pharmaceutical Assistance Programs (called SafeNetRx) helps Iowans in need of assistance with medications and medical supplies for little or no cost. SafeNetRx works by receiving donations from long-term care dispensing pharmacies, medical facilities, and individuals. The medications and supplies are inspected by a pharmacist, distributed to medical facilities and dispensed to Iowans in need. To be eligible for the program, a person must be at or below 200% of the federal poverty level.  For more information, you can contact the program directly at 866-282-5817.
4. Find help from drug manufacturers. Patient Assistance Programs, or PAPs, are programs offered by drug companies to help people pay for their medications. Through these programs, many drug manufacturers offer the drugs they make for free, or at a discount. Some PAPs are for people who don’t have insurance, while a few programs help people with Medicare Part D who don’t qualify for the Low Income Subsidy.
5. Explore drug charity programs. Several national charity programs exist that can help people with Medicare afford their medications. Many of these specifically focus on assisting people with chronic conditions and rare diseases. You can click this link to see a list of drug charity programs or visit NeedyMeds to find out what kind of assistance is available to you. Additionally, Iowa hospitals and clinics may also have support available from the 340B Drug Pricing Program. This is a federal program that requires pharmaceutical manufacturers to sell outpatient drugs at significant discounts (often 50% or more) to specific hospitals and clinics. The hospitals and clinics that receive these medications must use the savings to reduce medication costs for uninsured/low-income patients.  You can ask your hospital or clinic if they receive 340B Drug Pricing.
6. Check out coupon programs. Over the past few years, a number of private, for-profit companies have been created that offer medication discounts via physical cards or online discounts. These include companies such as GoodRx, Amazon, BlinkRx, and Cost Plus Drugs. These discounts cannot be used together with drug plans and may not be available at all pharmacies. You can find more information on these options by discussing them with your local pharmacy.
7. Don’t forget to compare plans during Open Enrollment! Every year from Oct. 15 to Dec. 7, people with Medicare can switch their prescription drug plans (whether you have Original Medicare or a Medicare Advantage plan) for the following year. It is a good idea to compare plans every year to ensure that your next plan is the most affordable option to cover your prescriptions. Remember, drug plans change annually as new contracts are negotiated between the companies that provide the plans and Medicare. You can independently conduct your own comparison using our handy tip sheet and find additional information on our website. Or you can get personalized help with a comparison by calling Iowa SHIIP/ SMP at 1-800-351-4664 and we will put you in touch with your local site.