How do discount cards and resources affect my Medicare Prescription Drug plan?

Answered by 32 licensed agents

Normally Discount Cards (Good RX and others) may discount your Prescription cost at certain pharmacies. This may be a way to save on Prescriptions when there is a higher copay. These companies may gather your information and market Medicare plans.

There are State Resources available to help with Prescription costs. There are many generic medications that could be $0 copay in Medicare Advantage or Standalone RX plan. Brand Medications can have copays.

State programs have an application and can take up to 2 weeks to 4 months to be approved. These programs have income guidelines to qualify. Most do not consider assets.

NJ PAAD

PA PACE

If you have questions on the state resources, please contact me for more information.

Answered by Leslie Helene Sussman on March 31, 2025

Broker Licensed in NJ, FL & PA

Answered by Leslie Helene Sussman Medicare Insurance Agent
It doesn’t. They won’t be used together. If you find that a discount price is cheaper than your Part D potion, by all means use the discount card.

Answered by Lt Col Tim Brown on May 27, 2025

Broker Licensed in TN, AL, CO & 10 other states

Answered by Lt Col Tim Brown Medicare Insurance Agent
Discount cards do not affect your Medicare or Drug plan. If you're not sure about your Medicare plan or your drug, it's a good idea to speak to a Medicare agent to review your options.

Answered by Gary Church on May 30, 2025

Broker Licensed in Ca, AZ, NV & TX

Answered by Gary Church Medicare Insurance Agent
They can supplement depending on the availability of your Rx and a plan in a given plan area. Discount cards are another option when regular Rx plan options are not available.

Answered by Mark Maliwauki on March 4, 2025

Broker Licensed in ID, AZ, CA & 15 other states

Answered by Mark Maliwauki Medicare Insurance Agent
They do not affect your Medicare insurance and they do not help your Medicare insurance.

Discount cards and programs line GoodRx are separate programs that work very well with purchasing inexpensive generic drugs in case you didn’t have a Part D drug plan.

Answered by Joseph Bachmeier on March 29, 2025

Agent Licensed in PA, AZ, DE & 5 other states

Answered by Joseph Bachmeier Medicare Insurance Agent
In most cases, discount cards or pharmaceutical company assistance is not available once a senior enrolls into Medicare Part D or Part C (with drug coverage). There are exceptions to this, but Medicare Part D/Part C can provide significant coverage support for most commonly prescribed medications.

Answered by Christopher Boyd on March 4, 2025

Agent Licensed in IN, KY, MI, OH, PA & TN

Answered by Christopher Boyd Medicare Insurance Agent
Discount cards can help lower your medicine costs, but the money you save with them doesn’t count toward your Medicare drug plan’s yearly out-of-pocket limit. In 2025, your Medicare Advantage drug plan will cap what you pay out of pocket at $2,000, but using discount cards won’t help you reach that cap faster.

Answered by Jason Hark, CMIS™ on June 4, 2025

Broker Licensed in IL, AL, AR & 16 other states

Answered by Jason Hark, CMIS™ Medicare Insurance Agent
They do not have a connection to your coverage. It is usually one or the other. So if you think your co-pay is too high with insurance, try GoodRx.

Answered by Bryan Smith on March 10, 2025

Broker Licensed in UT, AL, AR & 35 other states

Answered by Bryan Smith Medicare Insurance Agent
some seniors qualify for LIS (Low Income Subsidy or SPAP (State Pharmacy Assistance Program) ..... Pemiums coud be reduced

Answered by Vincent Esposito on March 26, 2025

Broker Licensed in NY, FL & NJ

Answered by Vincent Esposito Medicare Insurance Agent
Understanding Your Options Medicare Prescription Drug plans, also known as Medicare Part D, provide coverage for many prescription medications. However, navigating this coverage and ensuring affordability can be challenging. Discount cards and resources play a significant role in helping beneficiaries manage their medication costs. Here is an overview of how these tools can affect your Medicare Prescription Drug plan.

Discount Cards -

Discount cards are programs offered by various companies and organizations, providing discounts on prescription medications. These cards can be used at participating pharmacies to reduce the out-of-pocket costs for medications. While discount cards are not insurance, they can provide substantial savings.

How Discount Cards Work -

- Discount cards are generally available to anyone, regardless of whether you have insurance.

- The savings can vary widely depending on the medication and the pharmacy. It is essential to compare the discounted prices with your plan’s copayments and coverage.

- Present the discount card at the pharmacy when filling your prescription. The pharmacist will apply the discount, and you pay the reduced price.

Benefits of Discount Cards -

- Lower Costs for Non-Covered Drugs - If your Medicare plan does not cover a particular medication, a discount card can significantly reduce your costs.

- Savings on High Copayments - For medications with high copayments, a discount card may offer a lower price than your Medicare plan’s copayment.

- No Impact on Coverage - Using a discount card does not affect your Medicare coverage or benefits.

Programs that maybe available to you -

Extra Help, State Pharmaceutical Assistance Programs (SPAPs), Drug Manufacturer Assistance Programs, Charitable Foundations. To find out more please visit - https://www.cms.gov/medicare/health-drug-plans/medicare-prescription-payment-plan

Answered by Mark Cunningham on May 26, 2025

Agent Licensed in CO, FL, GA, NE & WY

Answered by Mark Cunningham Medicare Insurance Agent
A discount card can be used even if you have a Prescription Drug Plan or with the drug component that is included with a Medicare Advantage plan. Just remember to tell the pharmacy to ring up separately the drugs you want to use to pay for those drugs with your discount card.

Answered by Randall Taylor on June 3, 2025

Broker Licensed in TX, MI & WI

Answered by Randall Taylor Medicare Insurance Agent
They don’t. They are as if they didn’t exist as it does not count toward meeting your prescription deductible or your maximum out of pocket. Their cost is totally on you.

Answered by David Wiley on April 7, 2025

Broker Licensed in GA & NC

Answered by David Wiley Medicare Insurance Agent
Hello

1. Using discount cards does not count towards your Medicare deductible or out-of-pocket maximum.

2. Discount cards can not used with Medicare part D. You can only use one or the other, not both.

3. You can use a discount card to help cover medication not covered by your Medicare Part D plan.

If you need co-pay assistance, you can apply for EPIC. EPIC is a program that helps Medicare participates lower their drug co-payment or even eliminates them.

Answered by Nydia Flores on May 9, 2025

Broker Licensed in NY

Answered by Nydia Flores Medicare Insurance Agent
Discount cards can be a nice little hack for saving money on prescriptions, but they come with a catch, they don’t count toward your Medicare Part D out-of-pocket costs. Sometimes, they’ll get you a better deal than your plan’s copay, but other times, your Part D coverage is the smarter choice. Think of them as a backup tool in your savings toolbox—use them when they work in your favor, but don’t rely on them to help you hit your deductible or out-of-pocket max!

Answered by Ruben Trejo on March 4, 2025

Broker Licensed in TX, AL, AR & 27 other states

Answered by Ruben Trejo Medicare Insurance Agent
Using Discount Cards like GoodRx on some generic medications can be cheaper than using plans you pay for under Medicare Part D.

Please remember if you have a Social Security amount under $1,883 and Assets(not including your home and car) under $17,220 you may qualify for Extra Help. This means covered drugs will not cost more than $12.15 for a month's supply. Call Social Security at 1-800-772-1213 to get started. These are 2025 income/asset numbers.

Answered by Jim Schueth on March 25, 2025

Broker Licensed in NE, AZ, CO & 8 other states

Answered by Jim Schueth Medicare Insurance Agent
You will always have two options when you purchase a prescription drug: A) buy it through the Part D(rug) plan that was chosen during the Annual Enrollment period in the fall OR, B) purchase the Rx via the various online discount websites like pharmacychecker.com, GoodRx.com, simplecare.com, & costplusdrugs.com. + There are more than that! Whichever of those sources show the best copay price is the one to use. If you print a coupon, be sure to see if the pharmacy on that coupon is your usual pharmacy. At times, it pays to drive a few blocks further down the street if you want to save $$! Be sure to inform your doctor that for that one drug, he needs to fax a new Rx to the alternative pharmacy for you!

Answered by Steven Bleicher on May 26, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent
Good question! Here’s a simple answer. It’s one or the other. If you pay for a prescription using your Medicare Prescription drug plan card Then you work towards Medicare‘s catastrophic coverage (in 2025 that amount is $2K), Meaning that whatever you spend towards covered medication’s, gets you closer to hitting your $2000 out-of-pocket maximum a.k.a. catastrophic coverage. once you hit $2000 out-of-pocket you no longer pay a penny for any covered medication’s. Using your Medicare prescription drug coverage will typically give you a pretty big discount on your medication‘s as it is a pre-negotiated discounted rate between the drug company and the insurance company.

If you were to use something like goodRX, you may get a discounted medication but there is no cap to what you may pay throughout the year. Everyone’s situation is different, so for some folks, I’m a huge fan of good RX but for others I strongly encourage sticking to using your Medicare prescription drug plan.

Answered by Gregg Matheny on March 25, 2025

Agent Licensed in AZ & UT

Answered by Gregg Matheny Medicare Insurance Agent
A good pharmacy will try all discount plans that could save you money...and this has no impact on your Prescription Drug Plan.

Answered by John L Herman Jr on April 2, 2025

Broker Licensed in MD, DE & PA

Answered by John L Herman Jr Medicare Insurance Agent
Discount cards can be helpful in certain situations. Just be aware that any prescription purchases on discount programs do NOT count against your annual maximum out-of-pocket limit, so if you are trying to get to the limit as soon as possible so that your drug costs fall to zero, you may want to avoid discount cards.

Answered by Michael Crocker on March 28, 2025

Broker Licensed in SC

Answered by Michael Crocker Medicare Insurance Agent
They do not. You can use one or the other but most advantage plans ask that you use their plans. It is ultimately your choice.

Answered by Gretchen Morris on March 4, 2025

Broker Licensed in MN, AZ, FL & WI

Answered by Gretchen Morris Medicare Insurance Agent
You are only able to use a Drug Discount card if you are paying cash for your prescription.

You may not use the discount card in conjunction with your Prescription Drug plan .

Answered by Tammie Rutledge on April 3, 2025

Broker Licensed in WA, AZ, FL & ID, MT, OR & TX

Answered by Tammie Rutledge Medicare Insurance Agent
You can still use your favorite discount drug card if the price is cheaper than what the drug insurance plan pays

Answered by Cathy Barnett on June 4, 2025

Broker Licensed in TX, AL, NC & SC

Answered by Cathy Barnett Medicare Insurance Agent
You can't use prescription discount cards with your Medicare Part D benefits, but you can use them instead of them if the discount offers a lower price than your plan's cost.

Answered by Peter Yeh on March 21, 2025

Agent Licensed in CA & TX

Answered by Peter Yeh Medicare Insurance Agent
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.

Answered by Mary Hiatt on February 11, 2025

Agent Licensed in NE, AZ, IA, MO & TX

Answered by Mary Hiatt Medicare Insurance Agent
Discount cards and resources can help lower the cost of your prescriptions, but they cannot be used with your Medicare Part D plan. The Anti-Kickback Statute prohibits using drug coupons or discount cards alongside Medicare Part D. However, you can choose to use the cheaper option, which could be the discount card instead of your Part D coverage.

Here's a more detailed explanation:

Discount cards and online resources (like GoodRx) offer discounts on prescriptions, but they are separate from Medicare Part D coverage .

You cannot combine discount cards with your Medicare Part D plan .

The Anti-Kickback Statute prevents pharmaceutical companies from offering incentives or discounts that are then paid for by Medicare .

If a discount card offers a better price than your Medicare Part D co-pay, you can choose to use the card instead of your plan .

Using a discount card means your prescription cost will not count towards your Part D deductible or out-of-pocket maximum .

Consider using a discount card if your medication is not covered by your Part D plan or if it's cheaper than your Part D co-pay .

Many discount cards are free, while some may have a small yearly fee .

You can find information about discount cards by searching online or asking your pharmacist .

Answered by Fred Manas on May 23, 2025

Agent Licensed in NY, CT, DC & 7 other states

Answered by Fred Manas Medicare Insurance Agent
If you choose to use a discount card to pay for a prescription because it's cheaper than the Medicare Prescription Drug plan, you can use it for the cheaper price. However, it will not count towards your out-of-pocket expenses.

Answered by Aisha Saleem on March 13, 2025

Agent Licensed in MD & FL

Answered by Aisha Saleem Medicare Insurance Agent
They really don’t. Popular discount cards like “Good Rx “ can be used to give you a better price on some medications.

However, they do not count towards your Rx deductibles or true out-of-pocket costs. They are not insurance plans, so they are just standalone discounts!

Answered by Ross Landon on April 10, 2025

Agent Licensed in UT

Answered by Ross Landon Medicare Insurance Agent
You can use them to possibly save money on prescriptions. However they will not go toward your deductible if applicable. Sometimes the savings is well worth using them. Always ask the pharmacist which option will give you the best deal.

Answered by Randy Hill on April 1, 2025

Broker Licensed in OH, AL, AZ & 7 other states

Answered by Randy Hill Medicare Insurance Agent
You cannot use a discount prescription drug card in conjunction with Medicare Part D prescription drug plan. You must choose either to use your Part D prescription drug card or the discount card, you cannot use both at the same time.

Answered by Linda Bolan on March 12, 2025

Agent Licensed in IN

Answered by Linda Bolan Medicare Insurance Agent
How Discount Cards & Resources Impact Your Medicare Drug Plan?

They Can’t Be Combined at the Pharmacy

Medicare Part D doesn’t allow you to use a discount card (like GoodRx, GlicRx, etc.) at the same time as your Medicare coverage for the same prescription. You have to choose one at the pharmacy counter:

Use your Part D plan (counts toward your deductible and out-of-pocket costs), or

Use a discount card (may be cheaper, but won’t count toward Medicare costs)

Discount Cards Might Be Cheaper for Some Drugs

Sometimes, a discount card price is actually lower than what your Medicare plan would charge, especially for generics.

But remember:

The purchase won’t count toward your plan’s deductible or coverage gap.

You’ll need to track what you spend separately if you use both in the same year.

Manufacturer Assistance Programs

Some drug companies offer patient assistance or copay programs, but most can’t be used with Medicare. These are usually for people without insurance or in very specific hardship situations.

The Extra Help Program

If you have limited income, you may qualify for Extra Help, a Medicare program that:

Lowers your copays for medications

Eliminates or reduces your deductible

Covers the “donut hole” coverage gap

Talk to Your Medicare Broker or Agent

A trusted agent can:

Help you compare retail and plan prices

Find the most cost-effective pharmacy or plan

See if a Supplemental plan or changing your Part D plan is a better fit

Always ask the pharmacist which option is cheaper, your Medicare plan or a discount card, and choose what saves you the most without missing long-term benefits from your plan.

Answered by Ryan Ross on May 29, 2025

Broker Licensed in FL, GA, KS & 9 other states

Answered by Ryan Ross Medicare Insurance Agent
I’ve seen many seniors also keep a hold of discount cards in addition to their part D plan card. In some situations the discount cards can help to provide a more reasonable price for some medications.

Answered by Mitchell Nunn on June 4, 2025

Broker Licensed in FL, MA & NC

Answered by Mitchell Nunn Medicare Insurance Agent
Medicare Part D does not work with other discount cards. If the discount card is better, you can pick up the medicine thru your discount card but the spending will be not be counted toward the Part’s deductible and out of packet max.

Some of my customers use discount cards to pick up medicines that are not covered by the Medicare part D plan.

Most of the states if not every state have the assistant program. Like PAAD in NJ and PACE in PA, EPIC in NY. The Fed also the the low income subsidy plan (LIS) to help those who qualify to get medicines.

Answered by Charles Mai on May 5, 2025

Broker Licensed in NJ, CA, FL & 6 other states

Answered by Charles Mai Medicare Insurance Agent

Tags: Advice for Seniors Medicare Part D Prescription Drug

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