How Medicare Beneficiaries Can Save Money on Prescriptions

Please remember, if you use any type of discount cards or resources outside of your Prescription Drug plan, your costs will not count towards your Deductible nor towards your Maximum Out of Pocket.

Work With Your Healthcare Providers:

Your Pharmacist and Physician can provide valuable insights on cost-saving tips related to your specific medications. Ask about potential generic alternatives, switching to 90-day supplies, or utilizing pharmaceutical company discount programs. Hospital-based social workers can help you find both local and federal assistance programs that can help with medication costs, along with manufacturer savings programs for chronic conditions such as cancer.

Use a Free Prescription Discount Card or Coupon:

Some of the most popular programs are GoodRX, SaveOnRx, Blink Health, SingleCare, and WellRX. It’s worth noting that the Federal Trade Commission recently filed a complaint against GoodRx, alleging that the company violated the law by sharing personal health information about its users. GoodRx has agreed to pay a $1.5 million fine and stop sharing sensitive data with advertising companies. (The settlement still needs to be approved by the court.)

Join a Paid Prescription Savings Program:

With all the free prescription medication savings programs out there, you might wonder whether paid services are really necessary. It might come down to your personal preference, especially if you have a long-term relationship with a local pharmacy like Walgreens, which offers a $20 per year prescription savings club.

Or you could already be a member of a service like Amazon Prime, which has recently launched a prescription savings program for its members. While anyone can sign up for Amazon Prime, you’ll have to weigh the hefty $139 annual membership fee if you’re only signing up for the prescription savings and not using other Prime services like video or two-day shipping.

Before investing in a paid program, compare the savings (minus the fee) with free prescription drug savings programs.

Go Directly to the Drug Manufacturer for Discounts:

If the medication you need is a name brand without a generic available or if you prefer to use the name brand, you could find discounts directly from the drug manufacturer—but you typically must meet certain criteria.

Explore Online Resources:

You can visit the NeedyMeds website to search for medications by diagnosis or condition. You can review different drug manufacturer savings programs, find coupons, and explore rebates.

RXAssist is a database that allows you to search individual drugs and compare prices by pharmacy. Physicians can also use RXAssist to find drug safety net programs or representatives who can offer coupons or drug samples. To qualify for most patient assistance programs, you’ll need to be uninsured, a U.S. citizen, and meet income guidelines. For example, to qualify for Pfizer’s prescription assistance programs, income guidelines will vary by medicine, but start at “400% of the federal poverty level, adjusted for family size.” (For 2024 income, 400% of the federal poverty level is $60,240 for an individual.)

The Patient Access Network (PAN) Foundation:

The (PAN) Foundation is a non-profit organization based in the United States. Its mission is to help Americans pay for medical procedures and alleviate the financial burden associated with healthcare expenses. PAN focuses on supporting individuals living with life-threatening, chronic, and rare diseases. These patients often face significant out-of-pocket costs for their prescribed medications. PAN covers more than 70 diseases. If you’re dealing with a specific condition, check if there’s a relevant disease fund that can help you. PAN also provides financial aid for transportation costs related to medical appointments.

Use an Online Mail-Order Pharmacy:

Check out online pharmacies like Mark Cuban’s Cost-Plus Drug Company, Blink Health, GeniusRX and DiRx.  While you likely won’t be able to use your insurance at these online pharmacies, you might find that paying out of pocket will be at a lower price than you’d pay using insurance.

An obvious downside to mail-order pharmacies is that you won’t get your meds right away. If you need a medication right away, you’ll need to fill your first prescription locally and then transfer your prescription to the mail-order pharmacy.

Know Your Insurance Formulary:

With so many prescription drugs on the market, it’s hard for you or your doctor to know what will be covered by your prescription plan. But you can better equip yourself to save with your insurance plan’s formulary (the list of drugs covered by a prescription plan) at your side. When you get a new prescription, call your local insurance agent so she can look it up for you to see where it is on the formulary and what your co-pay will be.

Buy from Canada:

One of the most compelling reasons to consider buying prescription drugs from Canada is cost. Unlike the U.S., Canada regulates drug prices, resulting in significantly lower average costs for consumers. The Patented Medicine Prices Review Board (PMPRB) ensures that prices remain reasonable. As a result, American drug prices are, on average, 218% higher than their Canadian counterparts, even though the products are often identical. Canadian drugs undergo rigorous testing for safety, like the United States. Health Canada, akin to the FDA, ensures the safety of Canadian drugs. Canadian pharmacies require a prescription from an authorized Canadian practitioner. However, American doctors can call or fax prescriptions to Canadian pharmacies through a process called “cosigning”. For the most part, if drugs require prescriptions in the U.S., they are only available by prescription in Canada as well. Remember to consult with your healthcare provider and explore reputable Canadian pharmacies for a reliable experience.

The important thing to remember about prescription medication is that you will always be your own best advocate, and it’s okay to ask questions of your doctor and pharmacist about any medication you’re prescribed. You might be surprised how a single conversation about drug costs can help you and your healthcare providers find savings—both today and in the future.

Mary Hiatt is President of Mary the Medicare Lady (A non-government entity.) She is a member of a pharmacist-led organization that helps her clients source savings for medications.  She offers Educational Workshops on Medicare, Drug Savings, How to Stop Phone Calls, and more at no charge. See www.hiattagency.com or contact licensed independent agent Mary Hiatt for more information.