Saving Money & Medicare
Tips to Save Money on Expensive Prescription Drugs
The cost of prescription drugs has grown faster than inflation for over a decade, causing an increasing number of Medicare beneficiaries to make difficult choices.
If the cost of prescriptions and Medicare insurance is more than you can afford, your first step should be to see if you qualify for Medicaid, Low Income Subsidy (LIS) or other financial assistance programs. You can take a quick eligibility survey on the SHIIP-SMP website to learn more**: https://shiip.iowa.gov/eligibility-survey
If you do not qualify for financial assistance, there are a number of ways to cover or reduce the cost of your most expensive prescriptions. Below are tips to help you save money.
1. Always consult your doctor and care team before choosing to forgo taking a prescription that is too expensive.
- If you are having difficulty covering the cost of a prescription, share that information with your doctor and care team so they can help provide you with options and support. Most prescriptions have generic alternatives that can be more affordable than brand name drugs. In some cases where a generic option is not available, there may also be alternative prescriptions that your doctor would recommend.
2. Research and apply for patient assistant programs provided through pharmaceutical companies, foundations or community support groups.
- Many pharmaceutical companies have patient assistant programs that cover all or some of the cost of specific drugs, particularly if there is not a generic option available. Patient assistance programs will often require an application, and may have eligibility restrictions.
- There are also a number of national and local foundations and community support groups that offer funding depending on your specific diagnosis.
- You can search for patient assistant programs on the Medicare.gov website for a wide variety of prescriptions: https://www.medicare.gov/plan-compare/#/pharmaceutical-assistance-program
3. Look into prescription discount and coupon cards. In some cases, you may be able to find savings that allow you to purchase a prescription for less than you would pay through your insurance.
- The Iowa Drug Card is available for free to anyone and has savings options specific to pharmacies located in Iowa. You can learn more about how to get the Iowa Drug Card and how it works here: https://iowadrugcard.com/
- There are also free and/or subscription service options that have contracted discounts for a large number of drugs (i.e. GoodRx, WellRx, SingleCare). You may discuss these options with your pharmacist to see what they recommend, or if their pharmacy offers other special pricing or discounts.
- It is important to know that these programs are operated separately from any prescription coverage you have. SHIIP-SMP and the Iowa Insurance Division do not provide recommendations for any discount program.
4, The 340B Drug Pricing Programprovides financial support primarily to hospitals that serve a large number of low-income patients. The health care provider must participate in the Program, allowing them to purchase outpatient drugs at a discount from manufactures.
- To access discounts on prescriptions you must be a patient of a hospital, clinic or other entity that participates in the 340B Program. You should ask the facility where you get your health care if they are registered in the program and if your drugs can be covered. Coverage decisions are made on a prescription by prescription basis.
5. Consult your local SHIIP-SMP counselor during the Part D Open Enrollment Period (Oct. 15-Dec. 7) to compare Medicare prescription plans and see if there is an option that will better cover your specific drug list.
- Medicare prescription plans (Part D) renegotiate coverage and pricing with pharmaceutical companies and pharmacies every year. We recommend checking your plan annually to make sure you are still enrolled in the best and most affordable option for you. When September rolls around, reach out to your local SHIIP-SMP counselor to schedule an appointment: https://shiip.iowa.gov/find-a-shiip-counselor
** If you do qualify for the Low Income Subsidy, you are eligible to compare and change your prescription drug plan quarterly.