Category: Medicare

Medicare beneficiaries often live on a fixed income that’s stretched out under normal circumstances. So, with today’s inflation affecting the cost of food, healthcare, and other expenses, their standard of living could be severely diminished. Some may even have to choose between buying food and prescription drugs. (Reports indicate that poverty is rising among senior citizens.)

If you’re on Medicare and under financial stress, there are many ways to find relief! In last month’s article, I listed four resources to help reduce your Medicare premiums and out-of-pocket expenses (such as copays and deductibles). This month, I’m back to share four more tactics, all of which can help you save on prescription drug costs! Let’s get to it!

Pharmaceutical companies often manage Patient Assistance Programs (“PAPs”) to help low-income individuals with the cost of their medications. PAPs serve as an augmentation to Medicare beneficiaries’ existing Part D coverage. (Side note #1: Part D is the Medicare section that covers most outpatient prescription drugs.)

GoodRx is a website that helps you find the lowest price for prescription drugs at nearby pharmacies. To take advantage of their free service, all you have to do is:

1. Enter the name of your drug to compare the prices in your area.
2. Find the lowest price available on both generic and brand-name drugs.
3. Select the deal you want, then GoodRx will create a coupon you can show at the pharmacy.

Another potential way to reduce prescription drug costs is to communicate with your physicians openly. Don’t be shy if they prescribe a brand-name drug you can’t afford! Ask them for help. Perhaps they can give you samples or prescribe an equivalent generic medication.

The final cost-saving measure for prescription drugs is to explore other Prescription Drug Plans (“PDPs”) in your area. Fortunately, many PDPs are available, all of which have their own:

• Drug formulary. (Side note #2: A formulary is the list of generic and brand-name drugs covered by a PDP.) If your current plan’s formulary excludes one of your medications, you may find an alternative PDP that covers it (as well as your other medicines).
• Tiers. (Side note #3: PDPs often place drugs into different tiers, each with a different out-of-pocket cost. Typically, drugs in a lower tier will cost you less than drugs in a higher tier.) You may find an alternative PDP that has your medicines in lower tiers than your current plan.
• Preferred pharmacies. (Side note #4: PDPs often designate select pharmacies where beneficiaries can get their drugs at a lower cost.) If your current plan doesn’t label your favorite pharmacy as preferred, you may find an alternative PDP that does.

I hope the information in this and last month’s articles serve as a good starting point to help you save on Medicare costs. If you have tips that I didn’t list, please send them to insuritystreet@gmail.com so I can help as many beneficiaries as possible.

Medicare beneficiaries often live on a fixed income that’s stretched out under normal circumstances. So, with today’s inflation affecting the cost of food, healthcare, and other expenses, their standard of living could be severely diminished. Some may even have to choose between buying food and prescription drugs. (Reports indicate that poverty is rising among senior citizens.)

If you’re on Medicare and under financial stress, there are many ways to find relief! In this and next month’s articles, I’ll provide a list of resources that can help reduce your Medicare premiums and out-of-pocket expenses (such as copays and deductibles). Let’s get to it!

Medicare Savings Programs (“MSPs”) offer assistance with your hospital (“Part A”) and medical (“Part B”) expenses – especially the premiums. To qualify, your resources and monthly income must fall below certain limits that increase every year. (Side note #1: “Resources” are your stocks, bonds, and the money in your checking, savings, and retirement accounts.) You can apply for MSPs through your state’s Medicaid program.

Another cost-saving measure is to explore the Medicare Advantage (“MA”) Plans in your area. (Side note #2: There are two primary ways to get Medicare coverage. The first is through the government, which is known as “Original Medicare”. The second way is through a private insurance carrier, which is known as “Medicare Advantage”. MA Plans include the benefits of Original Medicare plus dental, hearing, vision, and other extra benefits.)

• Fortunately, many MA Plans are available, all of which have different designs. So, you may find one that, when compared to your current plan, better fits your needs and reduces your costs. (For example, if you have recurring appointments with a number of specialty doctors, you may discover an MA Plan with lower copays for specialists.)
• If you’re in good health (or a veteran who utilizes your VA benefits), the Part B premiums could be your largest medical expense. (Side note #3: In 2023, the Part B premium is $164.90 per month.) So, you may want to find an MA Plan with a “giveback” feature that lowers your Part B premium. (Side note #4: If you’ve seen the commercials about putting money back in your Social Security check, they’re referring to an MA Plan with a Part B “giveback”.)

(Side note #5: These side notes are piling up.)

Extra Help – also known as the Part D Low-Income Subsidy – is a federal government program that offers assistance with your prescription drug costs. Like the Medicare Savings Programs above, your resources and annual income must fall below certain limits to qualify. You can apply for Extra Help through the Social Security Administration.

If you’re not eligible for Extra Help, then Pennsylvania has two programs – called PACE and PACENET – that offer low-cost prescription drugs. Eligibility for either program is based on your previous year’s gross income.

I hope this serves as a good starting point for saving on your Medicare costs. I look forward to sharing additional resources next month!